Comparative Use of Upgraded and Conventional Electroanatomical Mapping Systems for Atrial Fibrillation Catheter Ablation

Purpose: To compare the procedural data and image integration accuracy between patients ablated with upgraded and conventional electroanatomical mapping (EAM) system for atrial fibrillation (AF).Methods: 60 patients with symptomatic AF (66±10 years) were enrolled. In 20 patients three dimensional (3D) orientation was provided by upgraded EAM (; CARTO 3: Group 1), and in 40 patients by conventional EAM (; CARTO-Xp: Group 2). After reconstruction of all 4 pulmonary veins (PV) and posterior wall of left atrium, subsequent 3D CT image integration was performed using either “Landmark” and/or “Surface” registration in both groups. The distance of all EAM points to corresponding points on the 3D CT cardiac surface were compared between the groups. Several procedural data were also evaluated. Complete PV isolation with bidirectional block and non-inducibility of sustained atrial arrhythmias were the procedural endpoint.Results: The distance error in group 1 tended to be lower as compared with group 2 but no significant differences could be found (1.3±0.9 vs 1.8±1.1 mm, P=0.11). Although no difference could be found with respect to total procedural time (137±16 min. vs 145±15 min.), number of radiofrequency application was tended to be lower (60±10 vs 79±28, P=0.08) and total fluoroscopic time was significantly lower (79±17 min. vs 94±26 min., P<0.05) in group 1.Conclusion: AF ablation using upgraded EAM system could have some expected degree of efficiency compared with that of conventional.