Abstract 13857: Catheter Ablation of Atrial Fibrillation Using a New Non-Fluoroscopic Sensor-Guided 3D Navigation Tool
In Introduction: A novel sensor-based electromagnetic 3D navigation system has been introduced that allows real-time catheter tracking in the environment of pre-recorded conventional 2D X-ray loops (MediGuide (TM), St. Jude Medical).
Hypothesis: The first clinical applications of the new technology for catheter ablation of atrial fibrillation (AF) will have positive impact on procedural parameters.
Methods: 49 patients (39 male patients, age 60 ± 10 yrs) with symptomatic AF were ablated using the new technology. Two steerable diagnostic EP catheters equipped with a sensor for non-fluoroscopic catheter navigation were used for anatomical reconstruction of the left atrium within an electro-anatomic mapping system (EAMS), for tagging of defined anatomical structures, and for their placement in the coronary sinus and right ventricular apex, respectively. Circumferential pulmonary vein isolation plus additional lines - if necessary - were performed with a conventional irrigated-tip catheter using conventional EAMS navigation. A matched cohort of 49 patients ablated conventionally with the EAMS plus fluoroscopy served as a control group.
Results: In all 49 patients the sensor-enabled catheters could be visualized and tracked non-fluoroscopically throughout the procedure. Complete pulmonary vein isolation was documented in each patient. Adverse events did not occur. Usage of the new technology significantly reduced fluoroscopy time from 31±12 min to 16±7 min compared to the control group (p<0.001). Procedure duration was not significantly different between the two groups.
Conclusions: The first clinical application of new sensor-guided technology in AF ablation revealed feasibility of highly precise non-fluoroscopic 3D catheter tracking within pre-acquired 2D cine-loops. With the system, we were able to significantly reduce x-ray needs without extending work-flow, although a sensor-equipped ablation catheter was not available yet.
- © 2011 by American Heart Association, Inc.