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

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Abstract

Background

The Rhythmia mapping system was recently launched and allows for rapid ultra-high-resolution electroanatomical mapping. We evaluated the feasibility, acute efficacy and safety of this novel system for ablation of atrial fibrillation (AF) and left atrial (LA) tachycardia (AT).

Methods and results

A total of 35 consecutive patients (age 64.3 ± 8.6 years, LA diameter 44.4 ± 5.8 mm) underwent catheter ablation for AF and/or AT. All procedures were performed using Rhythmia in conjunction with the Orion mini-basket catheter. Pulmonary vein isolation (PVI) and linear lesions were performed applying radiofrequency (RF) energy. PVI was confirmed by presence of entrance and exit block using the mini-basket catheter. In addition, pacing maneuvers assessed bidirectional conduction block across linear lesions. Procedure duration was 110.3 ± 33 min, fast acquisition mapping (FAM) time was 19 ± 9 min. A mean number of 10165 ± 5904 mapping points were acquired during the initial map and 6379 ± 3191 for a remap. A total number of 31 ± 15 RF applications were delivered within 45 ± 22 min. Total fluoroscopy time was 21 ± 5, 5 ± 2 min were used for FAM. We observed a significant learning curve for mapping duration (p = 0.01). Complications included pericardial tamponade (n = 1), transient air embolism in the right coronary artery (n = 1), and mild groin hematoma (n = 2).

Conclusions

The present study is the largest to describe experience of LA ablation procedures using Rhythmia. PVI was achieved in all patients. Applying this ultra high-resolution electroanatomical mapping system under routine conditions leads to a high level of confidence. More data will be mandatory before final conclusions can be drawn.

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    Authors and Affiliations

    1. Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany

      Christian Sohns, Ardan M. Saguner, Christine Lemes, Francesco Santoro, Shibu Mathew, Christian Heeger, Bruno Reißmann, Tilman Maurer, Johannes Riedl, Thomas Fink, Kentaro Hayashi, Feifan Ouyang, Karl-Heinz Kuck & Andreas Metzner

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    1. Christian Sohns
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    Correspondence to Christian Sohns.

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    C. Sohns and A. M. Saguner contributed equally to this work.

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    Sohns, C., Saguner, A.M., Lemes, C. et al. First clinical experience using a novel high-resolution electroanatomical mapping system for left atrial ablation procedures. Clin Res Cardiol 105, 992–1002 (2016). https://doi.org/10.1007/s00392-016-1008-7

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    • DOI: https://doi.org/10.1007/s00392-016-1008-7

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