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Direct Comparison of Point‐by‐Point and Rapid Ultra‐High‐Resolution Electroanatomical Mapping in Patients Scheduled for Ablation of Atrial Fibrillation
Author(s) -
ROTTNER LAURA,
METZNER ANDREAS,
OUYANG FEIFAN,
HEEGER CHRISTIAN,
HAYASHI KENTARO,
FINK THOMAS,
LEMES CHRISTINE,
MATHEW SHIBU,
MAURER TILMAN,
REIßMANN BRUNO,
REXHA ENIDA,
RIEDL JOHANNES,
SAGUNER ARDAN M.,
SANTORO FRANCESCO,
KUCK KARLHEINZ,
SOHNS CHRISTIAN
Publication year - 2017
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.13160
Subject(s) - medicine , ablation , atrial fibrillation , pulmonary vein , context (archaeology) , fluoroscopy , catheter ablation , cardiology , ablation of atrial fibrillation , nuclear medicine , surgery , paleontology , biology
Point‐by‐Point versus Rapid Ultra‐High‐Resolution Electroanatomical Mapping in AF Introduction Three‐dimensional electroanatomical mapping (EAM) is an established tool facilitating catheter ablation. In this context, the novel Rhythmia system sets a new bar in fast high‐resolution mapping. The aim of this study was to directly compare point‐by‐point versus rapid ultra‐high‐resolution EAM in patients scheduled for ablation of atrial fibrillation (AF) with focus on procedural data, acute success, and midterm clinical outcome. Methods and Results A total number of 74 consecutive patients (48/74 male) with symptomatic AF were scheduled to undergo pulmonary vein isolation (PVI) using either Carto or Rhythmia. The Carto‐guided procedures were performed using point‐by‐point acquisition according to our routine approach, whereas for Rhythmia, fast anatomical mapping was utilized. Comparing Rhythmia‐ versus Carto‐guided ablation approaches, we observed a significantly longer total mapping time (P = 0.001), longer total fluoroscopy time (P = 0.001), more delivered RF‐applications (P = 0.019), and longer total RF‐duration (P = 0.002). There was no difference regarding total ablation time (P = 0.707), total procedure duration (P = 0.99), and acute procedural success. During follow‐up, 84.8% of patients remained free from any AF/AT‐recurrence using Carto versus 88.2% when using Rhythmia (P = 0.53). From Kaplan–Meier analysis, the event rate estimations were 15% versus 13.5%, respectively. Conclusion The present study reports our first clinical experience using Rhythmia in direct comparison with the established Carto system for AF ablation. Our data clearly demonstrate that Rhythmia was proved to be effective and well applicable but more data will be mandatory before final conclusions can be drawn.