A novel wide-band dielectric imaging system for electro-anatomic mapping and monitoring in radiofrequency ablation and cryoablation

Abstract

Background and Objectives A novel wide-band dielectric mapping system, named as KODEX-EPD (EPD Solutions, Philips, Best, the Netherlands), was effectively used in the EA mapping for atrial fibrillation (AF) ablation. To date, only a few studies have concentrated on the application of the KODEX-EPD system for ablating supraventricular tachycardia or ventricular premature beats (VPBs) in human models. This study aims to assess the applicability and efficiency of a novel three-dimensional electro-anatomic (EA) mapping system to improve the success rate of ablation. Methods This study included 11 consecutive patients who underwent ablation after EA mapping with the KODEX-EPD system. Results All surgeries were successfully performed using the KODEX-EPD system, including 6 cases who underwent ablation of paroxysmal supraventricular tachycardia (PSVT), 2 cases who received ablation of VPBs from right ventricular outflow tract (RVOT), and 3 cases who underwent cryoablation of AF. For ablation of PSVT or VPBs, the operation time was 31.4 (range, 24.0–38.0) min, in which a median operation time of 2.9 min was used to create anatomic images, and the median fluoroscopic dose was 7.4 mGy. For ablation of AF, the operation time was 56.0 (range, 49.0–62.0) min, in which a median of 4.3 (range, 3.4–5.2) min was used for constructing left atrium map, and the median fluoroscopic dose was 15.0 mGy. The operation time and the fluoroscopic dose were greatly shortened for all surgeries. Conclusion The KODEX-EPD system is an effective and safe tool to guide the EA mapping, leading to improvement in the success rate of ablation. It can promote the ablation process with the reduced fluoroscopic dose, and it is also a promising tool for complex surgeries.

One-year outcomes of wide antral cryoballoon ablation guided by high-density mapping vs. conventional cryoballoon ablation for atrial fibrillation: a propensity score–matched study

“…Although additional ablation was performed to achieve a wide antral isolation, the number of cryoapplications needed to achieve PVI was smaller in the mapping group than in the other group. On the one hand, the KODEX-EPD cryoablation occlusion tool helped in achieving improved PVI by indicating the degree of PV occlusion and leakage navigation, thus helping to avoid cryoablation with poor balloon-tissue contact ( 30 , 31 ). On the other hand, continuous voltage mapping during cryoablation in the mapping group helped to locate low-voltage activity within the PV ( 32 ).…”

Exosomes and their derivatives as biomarkers and therapeutic delivery agents for cardiovascular diseases: Situations and challenges

“…Cardiovascular diseases (CVDs), including hypertension, heart failure (HF), atherosclerosis, stroke, ischemic heart diseases, etc., continue to be a significant cause of death worldwide. [ 14 , 19 , 20 ] It is predicted that the increasing incidence of CVDs will lead to more than 23.6 million deaths by 2030 globally. [ 21 , 22 ] Atherosclerosis is the major cause of CVD, and its physiopathology also includes the remodeling of blood vessels, which may cause blood flow restrictions and influence the cardiovascular system.…”