title: Impact of respiration on electroanatomical mapping of the right atrium: implication for cavotricuspid isthmus ablation.
abstract: OBJECTIVE
  Cavotricuspid isthmus (CTI) ablation for typical atrial flutter (AFL) has become the preferred treatment for this arrhythmia. The aims of this study were to assess the impact of respiratory gating (RG) on electroanatomical mapping of CTI and to assess the efficiency of CTI ablation guided by the Carto3® system equipped with the new respiration gating software.
  
  
  METHODS
  Forty-four consecutive patients (mean age, 60 ± 13 years; 25 male) undergoing cavotricuspid ablation for symptomatic common AFL were randomly assigned to CARTO™ mapping with or without enabling RG module (Group A, RG OFF, Group B, RG ON).
  
  
  RESULTS
  A significant reduction in mean RA volume, CTI central length and CS ostium maximum diameter has been observed in the RG maps. The mean total procedural, fluoroscopy and radiofrequency (RF) time were 102.9 ± 35.3, 10.6 ± 3.3, 22.9 ± 14.2 min in group A and 75.3 ± 21.7, 3.6 ± 4.5, 10.4 ± 5.7 min in group B, respectively (p < 0.05).
  
  
  CONCLUSIONS
  Electroanatomical mapping systems' accuracy may be strongly influenced by respiration movements. The current study showed that automatic respiratory gated acquisition resulted in a better visualization of CTI, and this determines a relevant reduction in fluoroscopy and RF times.
authors.affiliation: Division of Cardiology, Policlinico Casilino, ASL RM/B, Rome, Italy. gildo_deruvo@yahoo.com
authors.forename: Ermenegildo
authors.initials: E
authors.lastname: de Ruvo
authors.forename: Serena
authors.initials: S
authors.lastname: Dottori
authors.forename: Luigi
authors.initials: L
authors.lastname: Sciarra
authors.forename: Marco
authors.initials: M
authors.lastname: Rebecchi
authors.forename: Borrelli
authors.initials: B
authors.lastname: Alessio
authors.forename: Scarà
authors.initials: S
authors.lastname: Antonio
authors.forename: Lucia
authors.initials: L
authors.lastname: De Luca
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Martino
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Guarracini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fagagnini
authors.forename: Ernesto
authors.initials: E
authors.lastname: Lioy
authors.forename: Leonardo
authors.initials: L
authors.lastname: Calò
mesh_terms: D001282:Atrial Flutter / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D016009:Chi-Square Distribution; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005471:Fluoroscopy; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery*; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012119:Respiration; D012984:Software; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000503:physiopathology / Q000601:surgery*