AUTHOR=Gagyi Rita B. , Minciuna Ioan A. , Bories Wim , Szili-Torok Tamas 

TITLE=Charge density mapping demonstrates superiority in catheter ablation of post-surgical atrial tachycardias

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1453273

DOI=10.3389/fcvm.2024.1453273

ISSN=2297-055X

ABSTRACT=<sec><title>Introduction</title><p>Atrial tachycardia (AT) frequently occurs after cardiac surgery or surgical ablation procedures. The novel charge density-based mapping system (CDM) provides global chamber mapping and can detect crucial pathways of conduction; therefore, it has potential added value in catheter ablation (CA) of post-surgical ATs. We aimed to test the hypothesis that CDM-guided CA procedures are safe, feasible, and may improve outcome compared to conventional sequential 3D mapping (CARTO)-based CA.</p></sec><sec><title>Methods and results</title><p>Consecutive patients undergoing CA for post-surgical AT guided by CDM or CARTO were enrolled. Procedural safety and efficiency were analyzed. Acute success, one-year outcome was assessed. A total of 35 patients (mean age 60.8 ± 10.6 years, 42.9% female) underwent CA of AT using CDM (<italic>n</italic> = 20) and CARTO (<italic>n</italic> = 15). A total of 61 ATs were mapped (35 in CDM and 26 in CARTO group). Four patients had focal ATs, 22 macro re-entrant, and 8 patients had ATs with both mechanisms. No differences were found in procedural complication (CDM 3 vs. CARTO 1 patient, <italic>p</italic> = 0.61). There were no differences in procedure duration (185.9 vs. 147.9 min, <italic>p</italic> = 0.09), fluoroscopy dose (165.0 vs. 155.0 mGy, <italic>p</italic> = 0.31), RF application number (28.0 vs. 18.0, <italic>p</italic> = 0.17) or duration (1,251.5 vs. 1,060.0 s, <italic>p</italic> = 0.54). Acute success was 95.0% in CDM and 73.3% in CARTO group (<italic>p</italic> = 0.14). Cumulative AT recurrence rates were lower in CDM group compared to CARTO group (10.0% vs. 46.7%, <italic>p</italic> = 0.02).</p></sec><sec><title>Conclusions</title><p>The CDM system is feasible. Our data suggest that patients treated with CDM-guided CA developed fewer AT recurrences as compared to CARTO-guided procedures.</p></sec>