Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-PO02 - Poster Session II (ID 47) Poster

D-PO02-150 - Comparison Of Acute Procedural End Points For AcQMap Guided Catheter Ablation Of Persistent Atrial Fibrillation Vs Conventional Mapping Systems - A Single Centre Experience (ID 1033)

Disclosure
 S. James: Nothing relevant to disclose.

Abstract

Background: AcQMap system uses non-contact sensors to assess continuous activation of the atrium. It can highlight areas of abnormal conduction during AF and allow ablation strategy to be tailored to the individual patient’s substrate.
Objective: To compare procedure endpoints in patients undergoing catheter ablation (RFA) of persistent AF using the AcQMap system compared to a those using conventional mapping system.
Methods: Clinical / procedural data were collected for consecutive patients undergoing persistent AF RFA during a 2 year period. System choice for RFA was by operators preference /not randomised.
Results: 38 patients underwent AcQMap-guidedRFA ablation (PVI only =1) and 51 underwent ablation using standard mapping systems (PVI only =18). PVI only cases were excluded from further analysis.
Conventional group were younger(58+/-9.6 vs 62.7+/- 8 years) and had fewer previous RFA procedures (1.8+/- 0.6 vs 2.3+/- 0.8). Other demographics were well matched (table 1)
11 patients (29.7%) converted to sinus rhythm with RFA alone in AcQMap group compared to 1 (3%) of conventional group (p =0.004)
Duration of RF energy was lower in the AcQMap group (23min v 33, p 0.01)
AcQMap RFA sites were directed solely by mapping. Conventional group RFA strategy used were Box isolation 55%,, Roof line 33% ,LPV-Mitral line 36.%, RPV-Mitral line 12.1%, Cavo-tricuspid isthmus 12%, Fractionation Sites 36.4%
Force -sensing RFA catheters were used in all cases.
Conclusion: A patient specific, targeted AcQMap-based substrate approach for persistent AF RFA is associated with significantly higher rate of acute conversion to sinus rhythm, reduced ablation delivery but at the expense of longer procedure times
Table 1. Clinical / Procedural Details ForAcutus and Conventional Mapping AF Cases
VariableAcutus Systemn=37Carto/ Precision systems n =33P Value
Age (yrs)62.7 (8.4)58.0 (9.6)0.027
Male (%)32 (84.2)42 (82.4)ns
CHADS-VASc1.3 (1.2)1.1(1.0)ns
procedure number2.3 (0.8)1.6 (0.6)0.00016
procedure duration (mins)272 (65)214 (44)0.00002
Fluorosopy duration (mins)34 (14)22 (9)0.00003
RFA energy duration23 (12)(33 (14)0.0103
ablation to sinus rhythm (%)11 (29.7)1 (3.0)0.004
redo PVI + substrate ablation (%)32 (86,5)29 (87.9)ns
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