Abstract
Patients undergoing RF ablation to treat persistent AF (PersAF) may develop atrial flutter (AFL) during the procedure. Ablation of atypical AFL can be challenging but, recent advancements in high-density (HD) three-dimensional mapping strategies may help rapidly and accurately assess ablation targets to achieve successful outcomes in treating AFL. The Advisor™ HD Grid Mapping Catheter Observational Study (NCT03733392) was designed to quantify and characterize the utility of mapping with a market-released HD mapping catheter in AFL subjects undergoing ablation. This study was sponsored by Abbott Laboratories. Subjects undergoing mapping with the Advisor™ HD Grid Mapping Catheter, Sensor Enabled (HD Grid) for PersAF ablation were enrolled in this multi-center study, some of which were also in AFL. The aim of this study was to gather data regarding safety, mapping and ablation strategies, electrogram (EGM) quality, and outcomes. 15.2% (51/334) of enrolled subjects in this study were in AFL and of these subjects, 96.1% (49/51) were ablated for AFL (65.5yrs, 67.3% male). 81.4% (35/43) of the maps generated were late activation timing (LAT) and 16.3% (7/43) were peak-to-peak voltage maps. Median total mapping points collected and used were 7008 (IQR 3374-16811) and 1654 (IQR 900-2286), respectively, in a median of 11 (IQR 6-17) min per map. HD Grid identified substrates such as, low voltage (82.4%; 42/51) and fibrosis/scar (66.7%; 34/51) and detected signals of interest not identified by the ablation catheter in 90.2% (37/41) of subjects. Ablation strategies included targeting the mitral isthmus (38.8%; 19/49), roof line (36.7%; 18/49), and cavotricuspid isthmus (26.5%; 13/49). The mean procedure time was 171.4 ± 60.3 min with a fluoroscopy time of 13.7 ± 10.6 min and RF time of 36.1 ± 37.3 min. AFL was terminated in 93.9% (46/49) and non-inducible in 94.1% (16/17) of subjects. 84% (21/25) were free from recurrent AF/AT/AFL at 12 months. 2 SAEs, 7 SADEs, and 1 ADE were experienced in 17.6% (9/51) of subjects with none related to HD Grid. The results of this study support the utility of the Advisor™ HD Grid mapping catheter in generating LAT and voltage maps based on high-quality EGMs and for guiding efficient and effective ablation strategies to treat AFL.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
