학술논문
First Human Experience with Catheter Ablation Using Dipole Charge Density Mapping Integrated in Robotics in The Management of Atrial Fibrillation.
Document Type
Article
Author
Source
Subject
*CATHETER ablation
*SURGICAL robots
*ATRIAL fibrillation treatment
*TREATMENT effectiveness
*ECHOCARDIOGRAPHY
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Language
ISSN
2831-7335
Abstract
Background: Remote magnetic navigation (RMN) guided catheter ablation (CA) has previously demonstrated high efficiency and efficacy in atrial fibrillation (AF) ablation. Previously, only the CARTO 3D mapping system was integrated in the RMN system. Recently, a novel highresolution non-contact mapping system (AcQMap) can be used in combination with the RMN robotic system (AcQMap-RMN). Objective: To assess the feasibility by analyzing safety, efficiency, and efficacy of dipole charge density mapping in RMN guided ablation procedures for AF. Methods: All patients undergoing ablation for AF using the AcQMap-RMN system were included. The AcQMap creates echocardiographybased anatomy and identifies potential sources of atrial fibrillation such as focal firing, rotational activity, and localized irregular activation. Demographic, procedural and follow-up data were analyzed. Results: A total of 71 consecutive patients were included in this study (24 female, mean age 60.8±9.9 years, 49 redo and 22 de novo procedures). As primary outcome we report no major complications, while two patients developed groin hematoma, as minor postprocedural complication (2.8%). After completing PVI, 45 patients underwent AcQMap based substrate ablation. The mean procedure time was 170.5±43.3 min, mean ablation time 1749.6±950.7 s, mean radiation dose was 207.0 (IQR 128.5 - 349.5) mGy. Comparing patients undergoing substrate ablation with patients undergoing (redo) PVI-only, we documented higher numbers of application (36.0 vs 23.0, p=0.01), higher radiation doses (255.0 vs 142.0 mGy, p=0.03), and radiation times (26.2±8.2 vs 20.4±5.1 min, p<0.01) in patients requiring substrate ablation. In the persAF group 34 patients (72.3%) were AF-free at the end of the 12-month follow-up period. The overall freedom from any atrial arrhythmias was 68.0% in this patient group Conclusion: AcQMap-RMN integration is a feasible tool and provides high acute and long-term success rates associated with low complication rates in AF ablation. [ABSTRACT FROM AUTHOR]