CATHETER ABLATION OF PATIENTS WITH NON-PAROXYSMAL ATRIAL FIBRILLATION BY FOCAL AND ROTATIONAL ACTIVITY MAPPING USING CARTO FINDER SOFTWARE

Introduction: Catheter ablation in patients with non-paroxysmal atrial fibrillation (AF) still doesn´t give satisfactory results. One of the last developed methods in AF ablation is the ablation of regions with focal and rotational activities that contribute in maintaining of AF. CARTO Finder module was developed just to highlight the regions of repetitive focal and rotational activities during AF using endocardial high-density mapping. Our aim is to present initial results with the CARTO Finder module in non-paroxysmal AF.
Methods: Patients with symptomatic non-paroxysmal AF who were referred for catheter ablation were included in the study. The regions of focal and rotational activities in the left and righ atrium were mapped using Pentarey multipolar catheter and CARTO Finder module. The ablation consisted of pulmonary vein isolation, followed by ablation of highlighted regions of focal and rotational activities. If AF persisted after the ablation, electrical cardioversion was done. Holter recordings were done at 3, 6, 9 and 12 months during follow-up.
Results: A total of 13 patients (5 women), mean age 63.8+8.7 years, weight 93.2+17.6, were included. Mean duration of the procedure was 217.2+39 min, no complication occurred during the procedure. AF was present in all patients at the befinning of the procedure. The left atrial volume was 186.2+22.7 ml. Using the CARTO Finder module, 2.3+1.0 regions of focal, and 0.6+0.7 regions of rotational aktivity were found. Typical regions of findings were the base of the left atrial appendage and the endocardial side of the CS. Termination to SR or organization to regular atrial tachycardia occurred in only 2 patients, all other patients underwent electrical cardoversion. The mean follow-up time was 205.4+53.1 days, with 7 of 10 patients followed for longer than 6 months (70 %) maintained SR.
Conclusion: The acute termination of AF to SR or organization into a regular atrial tachycardia using CARTO Finder module was not frequent. On the other hand, clinical results in terms of SR maintenance was promissing in the pilot cohort of patients.