Turk Kardiyol Dern Ars. 2007; 35(1): 1-8

Initial experience with catheter ablation of tachycardias using a three-dimensional real-time position management and mapping system

Ata Kırılmaz, Fethi Kılıçaslan, Rifat Eralp Ulusoy, Bekir Sıtkı Cebeci, Mehmet Dinçtürk
Gata Haydarpasa Training Hospital, Cardiology Department, Istanbul, Turkey

OBJECTIVES
Three-dimensional real-time position management system (RPM) uses an ultrasound technique to display real-time movements of catheters, to construct anatomy of heart chambers, and to obtain activation/voltage mapping. This study presented our initial experience with the RPM system used for the ablation of supraventricular or ventricular tachycardias.

STUDY DESIGN
Ten patients (9 males, 1 female; mean age 30 years; range 20 to 75 years) underwent electrophysiologic studies and radiofrequency ablation using the RPM mapping system for the treatment of arrhythmias. Seven patients had accessory pathways, one patient had a slow pathway, and two patients had ventricular arrhythmias.

RESULTS
RPM-guided radiofrequency ablation was successful in six patients (60%). Failure of ablation was attributed to the RPM system in two patients, due to catheter instability and difficulties in steering to ablate the left lateral accessory pathways, and to the localization and characteristics of arrhythmias in two patients. The mean operation time was 146±45 min (range 60 to 180 min), with a mean fluoroscopy time of 43±22 min. No complications occurred during or after the procedure.

CONCLUSION
The RPM system provides satisfactory anatomical construction of heart chambers, marking of anatomic and electrophysiologic spots, three–dimensional real-time positioning of the catheters and activation/voltage mapping. It can be used to guide radiofrequency ablation of atrial and ventricular arrhythmias.

Keywords: Arrhythmia/surgery, catheter ablation/methods; echocardiography, three-dimensional; image processing, computer-assisted; tachycardia, ventricular/surgery

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