Co-Author(s):
Monica Lo, MD - Arkansas Heart Hospital
Firas Zahwe, MD, FHRS - Ascension St. John Hospital
Arjun Gururaj, MD - Nevada Heart and Vascular Center
Jose Martel, MD,MPH, FHRS - South Miami Hospital
Michael Bernard, MD, PhD - Ochsner Medical Center
Caroline Tao, PhD - Abbott
Rajesh Venkataraman, MD - Houston Methodist The Woodlands
Scripps Clinic and Prebys Cardiovascular Institute
9898 Genesee Ave Fl 3 La Jolla, CA 92037
Introduction | Objectives: A new software module, EnSite⢠LiveView Dynamic Display, utilizes the
Advisor⢠HD Grid Mapping Catheter to provide beat-to-beat, dynamic
display of regional mapping data. Early clinical experience suggests
that the combination of the two technologies may provide additional
clinical benefit and improve procedure efficiency. However, comparative
data has not been reported
Methods: Procedural data from experienced HD Grid mapping catheter users
collected in the U.S. in 2019 were compared to procedure data collected
from 17 U.S. centers during the first three months of commercialization
of the new software module in 2020. Procedural characteristics,
including procedure time, total RF time, fluoroscopy usage, and ablation
strategy were compared.
Results: A total of 87 HD Grid cases without dynamic mapping (67.8% paroxysmal
AF and 32.2% persistent AF) from 2019 were included in the analysis.
Data from 103 cases (65.0% paroxysmal AF and 35.0% persistent AF) were
collected using HD Grid mapping catheter and the new dynamic mapping
software. The ablation techniques and targets were similar between the
two datasets. The total RF time and fluoroscopy time was shorter in both
paroxysmal and persistent AF cases when the HD Grid mapping catheter was
used together with LiveView Dynamic Display (Table 1). Compared to the
historic dataset, the average procedure time was shorter in paroxysmal
AF cases and comparable in persistent AF cases when dynamic data was
available. Based on initial clinical experience during catheter ablation
of AF, incorporating dynamic mapping data was proved beneficial to
efficiency (mapping and ablation) and rapid gap identification (PVI and
ablation lines).
Conclusions: Compared to the historic dataset, total RF time and fluoroscopy time
was shorter when dynamic mapping was used during the case. Reduction in
total RF time and fluoroscopy time can improve procedure safety by
minimizing the creation of unnecessary lesions and exposure to
radiation. The critical regions uncovered by dynamic mapping data may
lead to better procedure outcomes and more durable lesions. Further
controlled studies which examine the long term outcomes when dynamic
mapping data is incorporated into the workflow may be warranted.
AFS 2021-28