How to Use a Variable Loop Circular Catheter to Perform Zero Fluoro Pulmonary Vein Isolation With Pulsed Field...

Area of Science:

• Cardiology
• Medical Devices
• Electrophysiology

Background:

• The Variable Loop Circular Catheter (VLCC), named VARIPULSE, is a new device for atrial fibrillation (AFib) ablation and 3D intracardiac echocardiography (ICE) guided electro-anatomical mapping.
• This study details a streamlined workflow for AFib ablation using the VLCC, reporting on feasibility, efficiency, and safety in the first 34 patients.

Purpose of the Study:

• To describe a streamlined workflow for AFib ablation using the VLCC and ICE.
• To evaluate the feasibility, procedural efficiency, and early safety of this novel approach in a cohort of 34 patients.

Main Methods:

• A retrospective review of 34 paroxysmal and/or persistent AFib patients undergoing VLCC mapping and ablation between January 2025 and May 2025.
• The workflow included general anesthesia, ultrasound-guided sheath placement, heparinization, 3D anatomical mapping with CARTOSOUND FAM, transeptal puncture, VLCC ablation, and closure.

Main Results:

• All 34 procedures were performed without fluoroscopy, achieving a median procedural time of 40.5 minutes.
• Procedure times consistently decreased to under 45 minutes after 10 cases per operator.
• No major acute or 30-day complications were observed in the study cohort.

Conclusions:

• The VLCC combined with ICE offers a feasible, efficient, and fluoroless workflow for AFib ablation.
• Early safety signals suggest this approach is promising, though larger prospective studies are needed for validation.
• This method avoids the need for multiple transvenous access sites, pre-procedural imaging, or complex catheter switching.