PO-04-034 NOVEL HIGH DENSITY OCTA-SPLINE MAPPING CATHETERS IMPROVED LEFT ATRIAL MAPPING EFFICIENCIES IN ATRIAL FIBRILLATION

Abstract

The standard of care for atrial fibrillation (AF) ablation involves a high-density mapping of the left atrium and has until recently been performed with a penta-spline multipolar mapping catheter capable of acquiring 10 points simultaneously. A novel high density, multi-spline (octa-splines/24 points simultaneously) mapping catheter with a close internal unipolar reference electrode became available, which may improve mapping efficiencies and image resolutions. Compare mapping efficiency the penta-spline and the novel octa-spline high density mapping catheters in patients who underwent left atrial mapping and ablation for atrial fibrillation. Procedure related complications were evaluated as well. The REAL AF registry is a prospective multi-center observational study of real-world clinical experience of AF ablation. Consecutive first-time AF ablation patients between August 2020-September 2022 from 3 sites with complete procedure data and corresponding electro-anatomical maps were included in this analysis. Patients with paroxysmal and persistent atrial fibrillation were included. Mapping data were analyzed via a cloud-based artificial intelligence analytic platform. A total of 706 eligible patients were included in this analysis (Penta-spline: 636; Octa-spline: 70). Patients in the octa-spline cohort were older, but otherwise comparable to those in the penta-spline cohort. Procedures using the octa-spline mapping catheter had a significantly lower mean mapping time (11.74 vs. 16.57 minutes, p=0.018), procedure time (52.86 vs. 70.32 minutes, p=0.006) as well as >4x higher mapping density (13,201 vs 3,142 points, p=0.001) relative to procedure performed with the penta-spline catheter (Figure). There were no statistically significant differences in the total RF time between the two groups. The novel octa-spline high density mapping catheter improved left atrial mapping efficiencies with significantly shorter mapping and procedures times and higher point density per map. As expected, the radiofrequency ablation duration is not different, while the percentage of scar trends towards a larger area with the octa-spline catheter likely as a result of a higher density, more uniform point collection.