AI Article Synopsis

  • The study evaluates a new technique called Delta Wave Automatic Mapping for effectively identifying ablation sites in patients with Wolff-Parkinson-White Syndrome (WPW) undergoing radiofrequency catheter ablation (RFCA).
  • A total of 50 patients were analyzed, with all accessory pathways successfully ablated and a median time-to-effect of 2.0 seconds, showing no recurrences during a follow-up period of about 10 months.
  • The workflow eliminates the need for manual site localization by leveraging existing algorithms, relying on specific historical electrical parameters to enhance ablation success and precision.

Article Abstract

Background: Despite the high success rate of radiofrequency catheter ablation (RFCA) in Wolff-Parkinson-White Syndrome (WPW), localizing the successful ablation site can be challenging and may require multiple radiofrequency (RF) applications.

Objective: This study aims to evaluate the efficacy of a novel workflow for the automatic and precise identification of accessory pathway ablation site, named Delta Wave Automatic Mapping.

Methods: Patients undergoing a first procedure for RF ablation of a manifest accessory pathway were included. Electro-Anatomical Mapping (EAM) was performed with the CARTO 3 system (Biosense Webster, Johnson & Johnson Medical S.p.a., Irvine, CA) leveraging auto-acquisition algorithms already present in the CARTO 3 software. Mapping and ablation were performed with an irrigated tip catheter with contact force sensor. Procedure success was defined as loss of pathway function after ablation. The number of RF applications required and time to effect were measured for each patient. Recurrences were evaluated during follow-up visits. Additionally, at the end of each procedure, historical predictors of ablation success were measured offline to evaluate their relationship with the successful ablation site found with the novel workflow.

Results: A total of 50 patients were analysed (62% APs right and 38% APs left). All 50 APs were successfully eliminated in each procedure with a median Time-to-effect (TTE) of 2.0 (IQR 1.2-3.5) seconds. No AP recurrences during a median follow-up of 10 (IQR 6-13) months were recorded. Offline analysis of successful ablation site revealed a pre-ablation delta/ventricular interval of ≤-10 msec in 52% of the patients and in 100% of the patients the signal related to the Kent bundle was identified.

Conclusions: The novel workflow efficiently localizes APs without requiring manual annotations. Historical endocardial parameters predicting success were measured offline for each case and they corresponded to the ablation target automatically annotated by the proposed workflow. This novel mapping workflow holds promise in enhancing the efficacy of RFCA in the presence of manifest APs.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371618PMC
http://dx.doi.org/10.3389/fcvm.2024.1449038DOI Listing

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