Initial experience of a novel mapping system combined with remote magnetic navigation in the catheter ablation of atrial fibrillation

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Excerpt

The EnSite Velocity mapping system (St. Jude Medical, Inc., St. Paul, MN, USA) is based on impedance field technology. It is influenced by impedance changes and differences in tissue types. Studies demonstrated that electromagnetic catheter localization offers a higher level of accuracy as it operates independently from tissue properties compared to impedance measurement‐based electric catheter localization.1 Recently, the next‐generation novel mapping system, EnSite Precision mapping system (St. Jude Medical, Inc.) was introduced, which combines both impedance and magnetic technologies. A circular magnetic mapping catheter (Advisor FL, Sensor Enabled; St. Jude Medical, Inc.) was designed with 10 electrodes and is capable of acquiring magnetic data during mapping. Magnetic data collected can be used for verification of navigation field stability. The stability of the created model during the ablation procedure is important. A shift of the model may lead to interruption of the procedure or even complications.
It has been over a decade since remote magnetic navigation (RMN) was introduced for catheter ablation in patients with cardiac arrhythmias.2 The main advantages of RMN‐guided catheter ablation are precision, flexible navigation, reduced fluoroscopy time, and safety.3 The Ensite Precision System, built on an open platform, allows physicians to choose any diagnostic or ablation catheters, including RMN.
As no data are currently available to the clinical utility of this novel mapping system combined with RMN for atrial fibrillation (AF) ablation, our objective is to assess the clinical utility of this novel 3D EnSite Precision mapping system combined with RMN (Niobe ES, Stereotaxis, Inc., St. Louis, MO, USA) for AF ablation. Navigation field stability is also evaluated at the end of procedure.
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