PMC5775442_01
A: Left anterior oblique (LAO) view of the patient's existing Watchman device and Achieve circular mapping catheter positioned within the left superior pulmonary vein. B: LAO view following inflation of the 28 mm cryoballoon at ostium of the left upper pulmonary vein and contrast injection showing adequate seal. Black arrows indicate Watchman device; white arrow indicates inflated cryoballoon.
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Achieve mapping catheter (Medtronic) and to guide positioning into each pulmonary vein. Adequate pulmonary vein occlusion was assessed by contrast injection and 1-2 freezes between 180 and 240 seconds long were delivered to each pulmonary vein (Figure 1).
A: Left anterior oblique fluoroscopic view of PentaRay mapping catheter and splines over exposed endothelial surface of the Watchman device. B, C: Carto 3 left atrial bipolar endocardial voltage map and left atrial appendage-like electrograms obtained from endocardial surface of Watchman device 9 months postimplantation.
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Surprisingly, bipolar voltage recordings obtained with the splines of the PentaRay catheter directly over the endothelialized surface of the Watchman device were normal in amplitude and even LAA-like (Figure 2).