RF ablation was performed point-by-point in accordance with the guidelines [1 (link)]. PV isolation was performed using the focal ablation strategy guided by the CARTO 3-D mapping system (Biosense Webster, Diamond Bar, CA, USA). All the procedures were performed under conscious sedation with local anasthetic. The double transseptal puncture was performed following the fluoroscopic guidelines. Immediately after the puncture, intravenous unfractioned heparin (UFH) was administered to maintain the target activated clotting time of 300–350 s. PV isolation was performed using 7F Navistar ThermoCool and 8F ThermoCool SmartTouch SF (Biosense Webster). In five patients RF ablation was performed using the “ablation index” algorithm.
Carto 3d mapping system
Manufactured by Johnson & Johnson
Sourced in United States
The CARTO 3D mapping system is a medical device used to create detailed, three-dimensional maps of the heart's electrical activity. The system utilizes a combination of advanced sensors, software, and visualization tools to generate these maps, which can aid healthcare professionals in diagnosing and treating various heart conditions.
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Lab products found in correlation
5 protocols using carto 3d mapping system
1
Pulmonary Vein Isolation Protocol
2
Comprehensive Cardiac Substrate Mapping Protocol
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Endocardial (Endo) access to the left ventricle (LV) was obtained via the retrograde and transseptal approaches in all patients. Epicardial mapping was performed in all patients, as part of the clinical ablation study. Pericardial puncture was performed using the subxiphoid approach. Substrate maps were created during sinus rhythm, using CARTO 3D mapping system (Biosense Webster, Inc., Diamond Bar, CA, USA). Mapping was performed using a PentaRay (PentaRay, Biosense Webster, Inc.) or DecaNav mapping catheter (DecaNav, Biosense Webster, Inc.) with impedance parameters scaled to ensure tissue contact. Normal myocardium was defined as tissue with a bipolar voltage >1.5 mV, dense scar was defined as a bipolar voltage <0.5 mV, and scar borderzone was defined as a bipolar voltage 0.5–1.5 mV, consistent with previously published data.1 (link),2 (link) Though debate exists regarding the optimal voltage cut-off to define Epi scar6 (link),7 (link) we sought to use a consistent value for both epicardium and endocardium as previously published,8 (link) in order to provide consistency to the APD measurements. Following this, activation mapping was performed if haemodynamically tolerated. Finally areas of late potentials and mid-diastolic potentials were identified.
3
Magnetic Navigation System for Cardiac Ablation
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The RMN Niobe ES (Stereotaxis Inc., St. Louis, Missouri), the CARTO 3D mapping system (Biosense Webster Inc., Carlsbad, California), and an open irrigated magnetic ablation catheter (NaviStar RMT ThermoCool; Biosense Webster Inc.) mainly constitute the magnetic navigation system for 3D electroanatomic mapping and remote ablation (Figure 1 ). Briefly, two permanent magnets are located on two sides of the radiological examination table. When the magnets are in the navigation position, a uniform magnetic field of 0.08 T can be created within the patient's chest. By changing the relative orientation of the magnets, effective control of the catheter deflection can be achieved.
4
Recurrent PsAF Ablation with Cryoballoon
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Patients with history of index PVI for PsAF and scheduled for a repeat ablation procedure for recurrence of the same arrhythmia were enrolled between August 2018 and February 2020. All index procedures for AF are performed as PVI with the cryoballoon in our center. All patients underwent both substrate mappings of the left atrium (LA) with the CARTO 3D mapping system (Biosense Webster Inc., Diamond Bar, CA, USA) and with AcM. Patients in which (1) direct-current cardioversion (DCCV) could not restore SR, (2) SR could not be maintained during mapping, (3) pacing during bipolar voltage mapping induced AF or (4) presented with one or more reconnected veins were excluded from the study. The study protocol was carried out in accordance with the ethical principles for medical research involving human subjects established by the Declaration of Helsinki and was approved by the local ethics committee of our Institution. All patients provided written informed consent to the ablation procedure.
5
Magnetic Navigation-Guided Ablation Protocol
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Procedure time was defined as the total time from the Navigant™ (Stereotaxis Inc, St. Louis, MO) ''open procedure'' to the Navigant ''close procedure'', in minutes. Clinical start time was the time at which the catheter registered in the CARTO™ 3D mapping system (Biosense Webster Inc. Irvine, CA) or the time of first applied magnetic field, which ever time was earlier. Clinical time was calculated as the time difference between clinical start time and the latter time of last applied field or last RF ablation application turned off. Mapping time was the time interval from clinical start time to first burn. Total X‐ray time and the control room's X‐ray time were defined as the total sum number of minutes fluoroscopy beam was activated and fluoroscopy beam was activated while magnets were in a navigate position, respectively. RF applications and RF time reflected the total sum number and minutes of ablation burns during the procedure, respectively.12 Navigation index, defined as the ratio of total radiofrequency time to the time from first burn to last burn, was utilized to indicate the efficiency of RMN‐guided ablation in this study. The higher the navigation index, the greater percentage of time was spent delivering RF treatment versus locating desired RF treatment locations.
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