Abstract
IntroductionThe AcQMap High Resolution Imaging and Mapping System was recently introduced. This system provides 3D maps of electrical activation across an ultrasound-acquired atrial surface.MethodsWe evaluated the feasibility and the acute and short-term efficacy and safety of this novel system for ablation of persistent atrial fibrillation (AF) and atypical atrial flutter.ResultsA total of 21 consecutive patients (age (mean ± standard deviation) 62 ± 8 years, 23% female) underwent catheter ablation with the use of the AcQMap System. Fourteen patients (67%) were treated for persistent AF and 7 patients (33%) for atypical atrial flutter. Eighteen patients (86%) had undergone at least one prior ablation procedure. Acute success, defined as sinus rhythm without the ability to provoke the clinical arrhythmia, was achieved in 17 patients (81%). At 12 months, 4 patients treated for persistent AF (29%) and 4 patients treated for atypical flutter (57%) remained in sinus rhythm. Complications included hemiparesis, for which intra-arterial thrombolysis was given with subsequent good clinical outcome (n = 1), and complete atrioventricular block, for which a permanent pacemaker was implanted (n = 2). No major complications attributable to the mapping system occurred.ConclusionThe AcQMap System is able to provide fast, high-resolution activation maps of persistent AF and atypical atrial flutter. Despite a high acute success rate, the recurrence rate of persistent AF was relatively high. This may be due to the selection of the patients with therapy-resistant arrhythmias and limited experience in the optimal use of this mapping system that is still under development.Supplementary InformationThe online version of this article (10.1007/s12471-021-01636-w) contains supplementary material, which is available to authorized users.
Highlights
Introduction The AcQMap High ResolutionImaging and Mapping System was recently introduced
Despite a high acute success rate, the recurrence rate of persistent atrial fibrillation (AF) was relatively high. This may be due to the selection of the patients with therapy-resistant arrhythmias and limited experience in the optimal use of this mapping system that is still under development
No recurrence of clinical arrhythmia was observed in 86% of the patients treated for atypical atrial flutter during a follow-up of 12 months
Summary
Introduction The AcQMap High ResolutionImaging and Mapping System was recently introduced. Initial experience with AcQMap catheter sible for driving and maintaining AF are thought to exist in persistent AF [3,4,5] This explains why PVI alone renders a much lower success rate in these patients [6, 7]. Current point-by-point mapping systems are unable to accurately display complex arrhythmias because of the sequential nature by which such systems acquire, post-process and display voltage-based contact signals.
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