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CARTO-guided vs. NavX-guided pulmonary vein antrum isolation and pulmonary vein antrum isolation performed without 3-D mapping: effect of the 3-D mapping system on procedure duration and fluoroscopy time

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Abstract

Purpose

Pulmonary vein antrum isolation (PVAI) guided by intracardiac echocardiography and a roaming circular mapping catheter is an effective treatment modality for atrial fibrillation. Unfortunately, the complexity of this technique leads to long procedure times and high fluoroscopy exposure. This study examined the effect of two different mapping systems on the procedural characteristics and clinical outcomes of PVAI for atrial fibrillation.

Methods

Referred patients underwent PVAI using a magnetic-based 3-dimensional (3-D) mapping (CARTO® System; group 1), a current-based system (EnSite NavX™; group 2), or fluoroscopy without 3-D mapping (group 3) between February 2004 and November 2009.

Results

Data were analyzed from 71 patients in group 1, 165 patients in group 2, and 197 patients in group 3. Baseline characteristics and measured long-term outcomes did not differ between the groups. Although patients in group 1 were more likely to undergo a concurrent flutter ablation (P = 0.01), they had significantly shorter procedure time, fluoroscopy time, and radiofrequency energy delivery time compared with group 2 and 3 patients. No difference was detected among the groups with respect to recurrence, mean time to recurrence, or number of PVAI procedures.

Conclusions

Use of a magnetic-based 3-D mapping system, which allows precise spatial localization of the ablation catheter, was associated with significantly lower procedure time, fluoroscopy duration, and radiofrequency energy delivery time during catheter ablation for atrial fibrillation compared with a current-based system and ablation performed without 3-D mapping, although measured short- and long-term clinical outcomes were similar.

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Acknowledgments

Financial support for medical editorial assistance was provided by Biosense Webster, Inc. We thank Tamalette Loh, PhD, ProEd Communications, Inc., for her medical editorial assistance with this manuscript.

Disclosures

Drs. Khaykin and Verma have received speaker’s honoraria from Biosense Webster, St. Jude Medical; and Medtronic. Biosense Webster, Inc. provided support for medical editorial assistance for preparation of this manuscript.

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Authors and Affiliations

  1. Heart Rhythm Program, Southlake Regional Health Centre, 105-712 Davis Drive, Newmarket, Ontario, Canada, L3Y 8C3

    Yaariv Khaykin, Richard Oosthuizen, Lauren Zarnett, Zaev A. Wulffhart, Bonnie Whaley, Carol Hill, David Giewercer & Atul Verma

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  1. Yaariv Khaykin
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Correspondence to Yaariv Khaykin.

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Khaykin, Y., Oosthuizen, R., Zarnett, L. et al. CARTO-guided vs. NavX-guided pulmonary vein antrum isolation and pulmonary vein antrum isolation performed without 3-D mapping: effect of the 3-D mapping system on procedure duration and fluoroscopy time. J Interv Card Electrophysiol 30, 233–240 (2011). https://doi.org/10.1007/s10840-010-9538-9

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