First clinical experience using a novel high-resolution electroanatomical mapping system for left atrial ablation procedures

Sohns, Christian; Saguner, Ardan M.; Lemeš, Christine; Santoro, Francesco; Mathew, Shibu; Heeger, Christian; Reißmann, Bruno; Maurer, Tilman; Riedl, Johannes; Fink, Thomas; Hayashi, Kentarō; Ouyang, Feifan; Kück, Karl‐Heinz; Metzner, Andreas

doi:10.1007/s00392-016-1008-7

Cited by 45 publications

(16 citation statements)

References 22 publications

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“…Fluoroscopy during radiofrequency ablation (RFA) of supraventricular tachycardia (SVT) exposes patients and operators to ionizing radiation. The demand for reducing radiation exposure by optimizing fluoroscopy or by the use of advanced technologies during these procedures is particularly important [1–4]. Previous reports have shown that the aim of zero-fluoroscopy during conventional ablation procedures can be reached [5].…”

Section: Introductionmentioning

confidence: 99%

First experience with zero-fluoroscopic ablation for supraventricular tachycardias using a novel impedance and magnetic-field-based mapping system

et al. 2018

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AimsZero- and near-zero-fluoroscopic ablation techniques reduce the harmful effects of ionizing radiation during invasive electrophysiology procedures. We aimed to test the feasibility and safety of a zero-fluoroscopic strategy using a novel integrated magnetic and impedance-based electroanatomical mapping system for radiofrequency ablation (RFA) of supraventricular tachycardias (SVTs).MethodsWe retrospectively studied 92 consecutive patients undergoing electrophysiology studies with/without RFA for supraventricular tachycardia (SVT) performed by a single operator at a single center. The first 42 (Group 1) underwent a conventional fluoroscopic-guided approach and the second 50 (Group 2) underwent a zero-fluoroscopic approach using the Ensite Precision™ 3-D magnetic and impedance-based mapping system (Abbott Inc).ResultsGroup 1 comprised 14 AV-nodal re-entrant tachycardia (AVNRT), 12 typical atrial flutter, 4 accessory pathway (AP), 2 atrial tachycardia (AT), and 9 diagnostic EP studies (EPS). Group 2 comprised 16 AVNRT, 17 atrial flutter, 6 AP, 3 AT, 2 AV-nodal ablations, and 7 EPS. A complete zero-fluoroscopic approach was achieved in 94% of Group 2 patients. All procedures were acutely successful, and no complications occurred. There was a significant reduction in fluoroscopy dose, dose area product, and time (p < 0.0001, for all), with no difference in procedure times. Ablation time for typical atrial flutter was shorter in Group 2 (p = 0.006).ConclusionsA zero-fluoroscopic strategy for diagnosis and treatment of SVTs using this novel 3D-electroanatomical mapping system is feasible in majority of patients, is safe, reduces ionizing radiation exposure, and does not compromise procedural times, success rates, or complication rates.

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Section: Introductionmentioning

confidence: 99%

First experience with zero-fluoroscopic ablation for supraventricular tachycardias using a novel impedance and magnetic-field-based mapping system

et al. 2018

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“…One patient ablated in the anterior sinus experienced recurrence at the 1‐month follow‐up with a VAs configuration change. The remaining patients did not experience a recurrence during the mean 7‐month follow‐up.…”

Section: Resultsmentioning

confidence: 95%

“…IntellaMap Orion (Boston Scientific, Marlborough, MA) is a mini‐basket array catheter with 64 flat mini‐electrodes (0.4 mm 2 , 2.5 mm center‐to‐center interelectrode space). Combined with the Rhythmia mapping system (Boston Scientific), ultra‐high density and resolution electroanatomic maps could be obtained rapidly and automatically . In this study, we mapped RVOT‐type VAs using the Orion catheter and Rhythmia mapping system to exploit the electrophysiological characteristics of the earliest activation of RVOT VAs under ultra‐high density and resolution mapping using mini‐electrodes.…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological characteristics of the earliest activation site in idiopathic right ventricular outflow tract arrhythmias under mini‐electrode mapping

Liu

Jiang

et al. 2019

Cardiovasc electrophysiol

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Introduction Right ventricular outflow tract ventricular arrhythmias (RVOT VAs) often originate in the voltage‐transitional zone. The target electrogram could be compromised by the architecture of the roving catheter. Mini‐electrodes could improve the mapping resolution, especially in low‐voltage areas. The aim was to assess the electrophysiological characteristics of the earliest activation site (EAS) of RVOT VAs during mapping using mini‐electrodes. Methods and Results Twenty‐seven patients with RVOT‐type VAs were mapped using Orion mini‐electrodes and the Rhythmia mapping system. Bipolar and unipolar electrograms were analyzed and compared with conventional ablation catheter recordings. Twenty‐five patients (25 of 27) were successfully mapped and ablated at the RVOT. At the EAS, all 25 (100%) patients exhibited local sharp potentials (spiky potential) at the VAs, and 88% (22 of 25) individuals showed reverse late potentials in adjacent sinus beats on the bipolar mini‐electrode recordings. Related unipolar electrograms manifested 20% “q‐plateau‐QS,” 76% “gross QS,” and 4% “late QS” patterns related to spiky potential voltages and advanced times. Compared with electrograms recorded by ablation catheter, bipolar mini‐electrode recordings exhibited significantly shorter spiky potential durations (P = 0.001) and a significantly increased incidence of the reverse late potentials (P = 0.041). Unipolar mini‐electrode recordings had a lower incidence ratio of “late QS” patterns (P = 0.039). Conclusion Compared with ablation catheter mapping, mini‐electrodes improved the mapping resolution of the EAS of RVOT VAs and exhibited shorter spiky potential durations and reduced incidence of “later QS” unipolar patterns.

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“…The Rhythmia Mapping System has already been successfully used in various types of arrhythmias, including atrial tachycardia, atrial fibrillation, atrioventricular nodal re-entry tachycardia, ventricular tachycardia in structural heart disease or in the healthy heart (7)(8)(9)(10)(11)(12)(13)(14)(15) . The principal part of the mapping system is a 8.5 F basket mapping catheter (Intelamap Orion, Boston Scientific), introduced into the target chamber.…”

Section: Discussionmentioning

confidence: 99%

Ultra-fast, high density 3D mapping (Rhythmia Mapping System) and catheter radiofrequency ablation for electrical storm – early single centre experience

Lenarczyk¹,

Pruszkowska²,

Morawski³

et al. 2017

Heart Beat

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First clinical experience using a novel high-resolution electroanatomical mapping system for left atrial ablation procedures

Cited by 45 publications

References 22 publications

First experience with zero-fluoroscopic ablation for supraventricular tachycardias using a novel impedance and magnetic-field-based mapping system

First experience with zero-fluoroscopic ablation for supraventricular tachycardias using a novel impedance and magnetic-field-based mapping system

Electrophysiological characteristics of the earliest activation site in idiopathic right ventricular outflow tract arrhythmias under mini‐electrode mapping

Ultra-fast, high density 3D mapping (Rhythmia Mapping System) and catheter radiofrequency ablation for electrical storm – early single centre experience

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