Direct Comparison of Point‐by‐Point and Rapid Ultra‐High‐Resolution Electroanatomical Mapping in Patients Scheduled for Ablation of Atrial Fibrillation

• Published in: Journal of cardiovascular electrophysiology Vol. 28; no. 3; pp. 289 - 297
• Main Authors: 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, KARL‐HEINZ, SOHNS, CHRISTIAN
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.03.2017
• Subjects: Action Potentials; Appointments and Schedules; atrial fibrillation; Atrial Fibrillation - diagnosis; Atrial Fibrillation - physiopathology; Atrial Fibrillation - surgery; Cardiac arrhythmia; Carto system; catheter ablation; Catheter Ablation - adverse effects; Catheter Ablation - instrumentation; Catheter Ablation - methods; Catheters; Clinical Competence; Disease-Free Survival; electroanatomic mapping; Electrophysiologic Techniques, Cardiac - instrumentation; Electrophysiologic Techniques, Cardiac - methods; Equipment Design; Germany; Heart Rate; Humans; Kaplan-Meier Estimate; Learning Curve; Postoperative Complications - etiology; Predictive Value of Tests; Pulmonary Veins - physiopathology; Recurrence; Reproducibility of Results; Rhythmia system; Surgery, Computer-Assisted - adverse effects; Surgery, Computer-Assisted - instrumentation; Surgery, Computer-Assisted - methods; Time Factors; Treatment Outcome; Carto system; atrial fibrillation; catheter ablation; electroanatomic mapping; Rhythmia system
• ISSN: 1045-3873; 1540-8167
• DOI: 10.1111/jce.13160

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.