First clinical experience using a novel high-resolution electroanatomical mapping system for left atrial ablation procedures.
BACKGROUND
The Rhythmia mapping system was recently launched and allows for rapid ultra-high-resolution electroanatomical mapping. We evaluated the feasibility, acute efficacy and safety of this novel system for ablation of atrial fibrillation (AF) and left atrial (LA) tachycardia (AT).


RESULTS
A total of 35 consecutive patients (age 64.3 ± 8.6 years, LA diameter 44.4 ± 5.8 mm) underwent catheter ablation for AF and/or AT. All procedures were performed using Rhythmia in conjunction with the Orion mini-basket catheter. Pulmonary vein isolation (PVI) and linear lesions were performed applying radiofrequency (RF) energy. PVI was confirmed by presence of entrance and exit block using the mini-basket catheter. In addition, pacing maneuvers assessed bidirectional conduction block across linear lesions. Procedure duration was 110.3 ± 33 min, fast acquisition mapping (FAM) time was 19 ± 9 min. A mean number of 10165 ± 5904 mapping points were acquired during the initial map and 6379 ± 3191 for a remap. A total number of 31 ± 15 RF applications were delivered within 45 ± 22 min. Total fluoroscopy time was 21 ± 5, 5 ± 2 min were used for FAM. We observed a significant learning curve for mapping duration (p = 0.01). Complications included pericardial tamponade (n = 1), transient air embolism in the right coronary artery (n = 1), and mild groin hematoma (n = 2).


CONCLUSIONS
The present study is the largest to describe experience of LA ablation procedures using Rhythmia. PVI was achieved in all patients. Applying this ultra high-resolution electroanatomical mapping system under routine conditions leads to a high level of confidence. More data will be mandatory before final conclusions can be drawn.
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany. c.sohns@asklepios.com.
Christian
C
Sohns
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.
Ardan M
AM
Saguner
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.
Christine
C
Lemes
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.
Francesco
F
Santoro
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.
Shibu
S
Mathew
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.
Christian
C
Heeger
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.
Bruno
B
Reißmann
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.
Tilman
T
Maurer
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.
Johannes
J
Riedl
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.
Thomas
T
Fink
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.
Kentaro
K
Hayashi
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.
Feifan
F
Ouyang
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.
Karl-Heinz
KH
Kuck
Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.
Andreas
A
Metzner
D055011:Ablation Techniques / Q000009:adverse effects; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002983:Clinical Competence; D022062:Electrophysiologic Techniques, Cardiac / Q000295:instrumentation*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011237:Predictive Value of Tests; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
Atrial fibrillation; Electroanatomical mapping; Pulmonary vein isolation