Introduction
Pulmonary Vein Isolation (PVI) has become the standard of care for rhythm control management in patients with symptomatic atrial fibrillation (AF). In the last decades, different ablation technologies have been developed to improve clinical outcomes as well as lesion quality and durability with an acceptable safety profile. “Single-shot” PVI modalities have been developed to improve procedural efficiency. A novel radiofrequency (RF) catheter (Globe; Kardium, Burnaby, Canada) with a multielectrode array design combines the functions of single‐tip catheters with the simplicity and efficiency of a balloon catheter.

Method
The Globe Catheter is a 30 mm spherical multielectrode array with 16 flat ribs equipped with 122 gold‐plated electrodes. Each electrode fulfills multiple functions, including electrograms recording, pacing, radiofrequency ablation, as well as measuring tissue contact and temperature. In our center, the pulmonary veins Isolation (PVI) with the Globe catheter was carried out with a temperature-guided ablation, using simultaneously multiple electrodes (up to 24), with individual power control of every electrode (target temperature 63°C). Ablation time was 3 minutes for each application, stopped sooner or adjusted as required. After RF delivery, the isolation of each PV was tested for entry and exit blocks.

Results
Five patients with symptomatic atrial fibrillation (3 with paroxysmal, and 2 with persistent AF) underwent a PVI at our center, between May and June 2022, using the Globe catheter. Successful acute isolation was achieved in all the patients. “Single-shot” isolation of individual pulmonary veins was observed in 12 of the 20 PVs (60%) with a max temperature of 63,4±0,9°C. The mean procedural time and ablation time were, respectively 113,2 ± 39,6 min and 19,6 ±8,1 min, with an observed improvement accordingly to the learning curve. The mean fluoroscopy time was 10.3 ± 3.1 minutes, where the mean dose area product was 460,8± 303 cGycm2. Esophageal temperature was monitored in all patients: only in 2 patients, the ablation delivery was stopped due to esophageal temperature (max 40°C). No complications occurred during the procedure or in the immediate post-interventional phase.

Conclusion
PVI isolation with the new multi-electrode array Globe offers advantages of the single-tip RF catheters with the possibilities of a fast “single-shot” PVI. In our initial experience, the use of this new technology appeared feasible and safe in the peri-interventional setting.