Primary Experience Of A Noncontact Balloon Catheter Mapping System

Objective To evaluate the feasibility, safety and effectiveness of catheter ablation of complicated arrhythmia guided by a noncontact balloon catheter mapping system. Methods Catheter ablation of twelve patients were guided by a noncontact balloon catheter mapping system. A 9F 64-electrode balloon catheter and a conventional 7F ablation catheter were positioned via a femoral artery or vein into the same heart chamber. By use of the recorded location of the ablation catheter tip, heart chamber three-dimensional geometry was established. Using a boundary element inverse solution, 3360 virtual endocardial electrograms were computerized and used to derive isopotential maps. Radiofrequency catheter ablation with linear or circular lesion was performed at the earliest activation sites or the isthmus guided by the locator system. Results Radiofrequency catheter ablation guided by the locator system was successful in 11 patients. The isopotential mapping showed that the arrhythmia were many types.The success rate of primary ablation was 91.7% (11/12). The average operation time was 137±38min. The average exposure time of X-ray was 24±7.6min. The average ablation times was 31.27 ± 5.61. There were no complications during and after the procedure but one AF patient. In 6-32 months follow-up no relapse occurred in 12 patients but one VT patient and one PAF patient. Conclusions The noncontact mapping system described in this study computes accured isopotential maps that are used as a useful guide for catheter ablation of tachycardia, especially for hemodynamically unstable and nonsustained tachycardia. It is also suitable for understanding the electrophysiologic mechanism of complicated arrhythmia.