Catheter Ablation of Arrhythmias Exclusively Using Electroanatomic Mapping: A Series of Cases

Background

Catheter ablation is a treatment that can cure various cardiac arrhythmias.Fluoroscopy is used to locate and direct catheters to areas that causearrhythmias. However, fluoroscopy has several risks. Electroanatomic mapping (EAM)facilitates three-dimensional imaging without X-rays, which reduces risksassociated with fluoroscopy.

Objective

We describe a series of patient cases wherein cardiac arrhythmia ablation wasexclusively performed using EAM.

Methods

Patients who presented with cardiac arrhythmias that were unresponsive topharmacological therapy were prospectively selected between March 2011 and March2012 for arrhythmia ablation exclusively through EAM. Patients with indicationsfor a diagnostic electrophysiology study and ablation of atrial fibrillation, leftatrial tachyarrhythmias as well as hemodynamically unstable ventricular arrhythmiawere excluded. We documented the procedure time, success rate and complications aswell as whether fluoroscopy was necessary during the procedure.

Results

In total, 11 patients were enrolled in the study, including seven female patients(63%). The mean age of the patients was 50 years (SD ±16.5). Indications for theinvestigated procedures included four cases (35%) of atrial flutter, three cases(27%) of pre-excitation syndrome, two cases (19%) of paroxysmal supraventriculartachycardia and two cases (19%) of ventricular extrasystoles. The mean procedureduration was 86.6 min (SD ± 26 min). Immediate success (at discharge) of theprocedure was evident for nine patients (81%). There were no complications duringthe procedures.

Conclusion

This study demonstrates the feasibility of performing an arrhythmia ablationexclusively using EAM with satisfactory results.