The Importance of the Spatial Relationship between the Position of the Non-contact Mapping Balloon Array and the Arrhythmogenic Target Sites for Successful Catheter Ablation

Abstract

Back ground: Three-dimensional mapping systems such as the non-contact mapping system (EnSite) have been utilized for radiofrequency catheter ablation (RFCA) in cases with various kinds of arrhythmias. Methods: An EnSite system was utilized for RFCA in 12 patients with right-sided atrial tachycardia (AT). The patients were classified into two groups according to the focus of the AT in the right atrium (RA). The patients in whom the EnSite array was positioned near the focus of the AT were defined as group A, whereas those patients in whom the EnSite array was located less near the focus were defined as group B. RF energy was applied under the guidance of the mapping with the EnSite array. We investigated the relationship between the position of the EnSite array and the focus of the AT in terms of the mapping accuracy in both groups. Results: Even though the accuracy of the mapping of the breakout site and arrhythmia origin was comparable between groups A and B, the distance between the successful CA sites and the presumed AT focus according to the EnSite mapping was significantly shorter in group A than group B. Conclusions: As the location of the focus of the AT becomes closer to the proximal and distal ends of the ESB, the mapping accuracy deteriorates.