Comparative study of electroanatomical and conventional mapping and catheter ablation of atrial flutter

Objective To evaluate the clinical benefits of electroanatomically guided mapping and radiofrequency ablation under Carto system for atrial flutter(AF) by comparison to conventional method.Methods Thirty AF patients were included.The conventional method was applied to 16 cases as control group.Three dimensional electroanatomical map of the atrium of interest was created using Carto system during AF in 14 cases as Carto group.The success rate,operation time,fluoroscopic time,complications and follow-up findings were compared between two groups.Results In control group,there were 14 cases with typical AF and 2 with atypical AF.Among them 15 cases had instantaneous successful ablation.In Carto group,all 14 cases(11 with typical AF including 4 cases combined with atrial fibrillation and 3 with atypical AF including 1 with AF after surgical replacement of bicuspid valve and aortic valve) had instantaneous successful ablation.Comparing Carto group with control group,the fluoroscopic time was significantly shorter,(36.1±8.7) min vs(48.5±19.1) min(P0.01),but the operation time was longer,(224.6±45.3) min vs(181.4±61.6) min(P0.05).No serious complications occurred in both groups.After follow-up of 4-8 months,one patient with AF in control group reoccurred and underwent second ablation with a successful result.Conclusion This study demonstrates that electroanatomically guided mapping and ablation of AF is safe and effective,and it especially is more efficient than conventional method on the decrease of flouroscopic time.The Carto electroanatomical mapping system has orientational and memorial functions,which can accuratly locate targets and judge the succesion of linear injury especially in some complicated cases.