Co-Author(s):
Jose Martel, MD,MPH, FHRS - South Miami Hospital
Michael Bernard, MD, PhD - Ochsner Medical Center
Nicholas Olson, MD - Scripps Clinic and Prebys Cardiovascular Institute
Kevin Jackson, MD - Duke University Medical Center
Kevin Thomas, MD, FHRS - Duke University Medical Center
John Day, MD - Intermountain Medical Center
Sri Sundaram, MD, FHRS - South Denver Cardiology Associates
Toshimasa Okabe, MD - The Ohio State University Wexner Medical Center
Jonathan Piccini, MD, MHS, FACC, FAHA, FHRS - Duke University Medical
Center
Caroline Tao, PhD - Abbott
Rajesh Venkataraman, MD - Houston Methodist The Woodlands
Arkansas Heart Hospital
7 Shackleford W Blvd, Little Rock, AR 72211
Introduction | Objectives: A novel dynamic mapping software became commercially available in the
U.S. in July 2020. EnSite⢠LiveView Dynamic Display utilizes the
Advisor⢠HD Grid Mapping Catheter to display beat-to-beat, dynamic
regional mapping data. Procedural characteristics and clinical
utilization of this novel software have not yet been reported from U.S.
centers.
Methods: Procedural data were prospectively collected from over 30 operators in
18 U.S. centers during the first three months of commercialization
Procedural characteristics recorded included procedure time, total RF
time, workflow preference, and fluoroscopy time.
Results: A total of 119 cases were collected from July to September 2020. A
steerable sheath was used with the mapping catheter in 63 cases (53%).
Double transseptal access was observed in 85 cases (71%). LiveView
Dynamic Display was used in a variety of cases including AF, VT, and
atypical flutter. The EnSite AutoMap module was used in conjunction with
the dynamic display in 50 cases (42%). Visualization of real-time
mapping data from the current location of the HD Grid mapping catheter
was commonly used after traditional full-chamber maps. LiveView was also
used as a pulmonary vein isolation (PVI) confirmation method in 49 cases
(41%). The most common reported usage of the LiveView Dynamic Display
was PVI confirmation/gap identification (81%), ablation line gap
identification (58)%, and identification of breakthrough activation
(45%)* note total exceeds 100%, multiple usages per case were
reported.
Conclusions: Initial experience in the U.S. demonstrated the diverse clinical
utilization of LiveView Dynamic Display, including atrial and
ventricular arrhythmias. The dynamic display of regional signals allows
for rapid identification of ablation targets. When used during RF
delivery, real-time assessment of regional activation patterns helped
improve outcomes by rapidly identifying critical ablation location and
ensuring successful lesion delivery. Further study which examines the
impact of dynamic display on procedure workflow and efficacy may be
warranted.