Treatment of macro-reentry atrial tachycardia with very high-power, short-duration, temperature-controlled ablation of anterior line using an open-irrigated ablation catheter with microelectrodes

Objective: Background: Case Report: Conclusions: Unusual clinical course Treatment of atrial fibrillation and atrial tachycardia (AT) with catheter ablation results in high rates of success with the procedure and on long-term follow-up. A novel ablation catheter with a very high-power, short-dura-tion (vHPSD) ablation mode using 90 W for 4 s has been introduced, which could improve safety and efficacy of catheter ablation, especially for pulmonary vein isolation (PVI). To date, vHPSD mode has only been evaluat-ed for treatment of PVI, but it could be an efficient technique for linear lesions. Here, we present the first use of the novel vHPSD mode alone for catheter ablation in a patient with peri-mitral AT (PMAT). A 74-year-old man presented with symptomatic AT. An electroanatomic reconstruction of his left atrium showed PMAT with a potential critical isthmus on the anterior wall. Therefore, ablation of an anterior line was performed. The patient’s AT stopped after 10 applications and less than 40 s of radiofrequency (RF) ablation. Afterward, the anterior line was completed with a total of 29 applications of vHPSD and a RF time of 116 s. PVI and block-age of the cavotricuspid isthmus also were performed. The total procedure time was 107 min. No periproce-dural complications occurred. The present case demonstrates the safety and efficacy of treatment of AT with a novel catheter that delivers vHPSD ablation to an anterior line.