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, EnSiteā„¢ LiveView Dynamic Display, utilizes the Advisorā„¢ 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