Nonfluoroscopic three-dimensional mapping for arrhythmia ablation: Tool ortoy?

Arrhythmia Ablation with Nonfluoroscopic 3D Mapping. Introduction: Conventi onal mapping and ablation rely on fluoroscopy, which can result in imprecis e positioning of the ablation catheter and long fluoroscopic exposure times . We evaluated a nonfluoroscopic three-dimensional mapping system, termed C ARTO, and compared the results of ablation using this technique with those of conventional mapping. Methods and Results: We compared the results of 88 arrhythmia ablations (79 patients) using CARTO with 100 ablations (94 patients) using the conventio nal technique. The ablations mere separated into four groups: (1) AV nodal reentrant tachycardia (AVNRT); (2) atrial tachycardia/ flutter; (3) ventric ular tachycardia (VT); and (4) bypass tract tachycardia. We compared the su ccess rate, complications, and fluoroscopy and procedure times. The ablatio n outcomes were excellent and comparable in all four types of the arrhythmi as between the two techniques. Major complications included one cardiac tam ponade in each group and one second-degree AV block in the conventional gro up. Fluoroscopy time was shorter using the CARTO technique: 10 +/- 7 versus 27 +/- 15 minutes for AVNRT (P < 0.01), 18 +/- 17 versus 44 +/- 23 minutes for atrial tachycardia and flutter (P < 0.01), 15 +/- 12 versus 34 +/- 31 minutes for VT (P < 0.05), and 21 +/- 14 versus 53 +/- 32 minutes for bypas s tract tachycardia (P < 0.01). Procedure times were similar except for the bypass tract patients, which was shorter in the CARTO group, 4 + 1.3 versu s 5.5 +/- 2.5 hours (P < 0.01). Conclusion: The electroanatomic three-dimensional mapping technique reduced fluoroscopy time and resulted in excellent outcome without increasing the procedure time.