Mapping and catheter ablation of cardiac tachyarrythmias under the guidance of Carto system / 中国介入心脏病学杂志

ABSTRACT

Objective To evaluate clinically electroanatomical mapping and ablation of cardiac arrhythmias under the Carto system. Methods Fifty-six patients with various tachycardias indicated for electrophysiological study and radiofrequency ablation were included in this study, among of whom, 49 suffered from supraventricular tachycardia, and 7 ventricular tachycardia (VT). Carto system was utilized during ongoing tachycardia or sinus rhythm, 7F Navi-Star catheter was introduced into the interested cardiac chamber and underwent three-dimensional electroanatomical mapping. The mechanism and origin of cardiac arrhythmia were assessed by activation and propagation map, with which to guide radiofrequency ablation. Results The success ablation rate was 94.6% (53/56). One right accessory pathway (AP), one atrial tachycardia (AT) and one atypical atrial flutter (AF) had failed session. The procedure time was 128?59 minutes, and the fluoroscopic time 14?12 minutes. One patient had complcation of pneumothorax. No conduction block occurred. After follow-up of 1-14 months, one left AT recurred and had another succssful session. Conclusion The study demonstrates that Carto system is a safe and effective tool and may be applied for mapping and ablation of various tachyarrhythmias. It is helpful to guide catheter ablation and shorten fluorocopic time by its ability of associate intracardiac electrograms with their three-dimensional anatomic structure. It also lessen complication and recurrence by tagging the critical cardiac structures and utilize its location memory function. Our experience suggest that carto system has important role in the guidance of mapping and ablation in AT、AF、VT and complex or recurrent AP cases.