m-FAM workflow with Pentaray/ablation catheter (group 2):
The Pentaray catheter was introduced through an SL1 sheath or steerable Agilis sheath into the left atrium. The Pentaray catheter was first introduced deep in the PVs and then positioned at the PV ostium. The Pentaray mapping catheter was replaced with the ablation catheter. To better define the pulmonary vein antrum, the ablation catheter was used to tag magnet points at the pulmonary vein ostium represented by the drop point from the left superior to the left inferior and vice versa, the drop point from the left superior to the left atrial appendage at the ridge, the drop point from the lower quadrant of the left inferior to the left atrium and the drop point from the right superior to the right inferior on the septal side. At this moment the m-FAM algorithm was initiated to create a three-dimensional reconstruction of the left atrium. The accuracy of the m-FAM reconstruction and location of the specific landmarks at the pulmonary vein ostium were checked with fluoroscopy and ICE visualization (fig. 1 and 2).
In case of lack of accuracy of the initial m-FAM reconstruction, re acquisition of the magnet points at the pulmonary veins drop-points and LA body was performed and the software algorithm was reinitiated.
The time required to achieve the M-FAM reconstruction and fluoroscopy time were also compared between the ablation and Pentaray workflows.