Sapphire blue

Patients were studied in the post-absorptive state. Class I and III anti-arrhythmic medications were discontinued for > 5 half-lives (>30 days for amiodarone). Catheters were advanced to the right atrium (RA), coronary sinus and transseptally to left atrium (LA). Contact basket catheters (FIRMap, Abbott) were positioned in RA then LA for AF mapping, based upon 3-dimensional electroanatomic imaging (NavX, St Jude Medical, Sylmar, CA; or Carto, Biosense-Webster, Diamond Bar, CA). This catheter consists of 8 splines, each with 8 electrodes, totaling 64 electrodes, which cover >70% of each atrium [31 (link)]. Within a spline, electrodes are separated by 4–6 mm, and spacing between splines is mostly within 20% of that range [31 (link)]. Ablation was guided prospectively at regions of interest identified by a commercial system (RhythmView^™, Abbott, Inc.) by delivering radiofrequency energy via an irrigated catheter (Thermocool, Biosense-Webster; or Sapphire-Blue, St Jude Medical) at 25–35 watts.

Circumferential PVI was performed in all 29 patients point by point using irrigated catheters (Cool-Flex/TactiCath/Sapphire-Blue, St. Jude Medical). Energies ranging 25–35 W were delivered via conventional ablation in both pairs of pulmonary veins. Additionally, FIRMap 64-poles mapping catheters were consecutively placed in the right and left atrium for 3-dimensional electroanatomic imaging (NavX, St. Jude Medical). Cather placement was achieved via vein access through the femoral vein reaching the right atrium and later to the left atrium through transeptal punction. In patients arriving in sinus rhythm electrical burst pacing was used to induce AF (Rodrigo et al., 2020 (link)).