Key result
Rhythmia HDM-guided catheter ablation demonstrated a 12-month pooled success rate of 71.6% for atrial fibrillation and 71.2% for atrial tachycardia.
Why the study?
Ultra-high-density mapping is increasingly used to guide catheter ablation in cardiac arrhythmias, but a systematic evaluation of long-term outcomes had not been performed.
Does Rhythmia HDM-guided catheter ablation improve outcomes in patients with atrial fibrillation or atrial tachycardia?
Meta-Analysis (n=1,768)
Does Rhythmia HDM-guided catheter ablation improve outcomes in patients with atrial fibrillation or atrial tachycardia?
Rhythmia HDM-guided catheter ablation shows high acute success rates but moderate 12-month long-term success (71.6% for AF, 71.2% for atrial tachycardia), with limited prospective data comparing it to conventional ablation.
Aim: Ultra-high-density mapping (HDM) is increasingly used for guidance of catheter ablation in cardiac arrhythmias. While initial results are promising, a systematic evaluation of long-term outcome has not been performed so far. Methods: A systematic review and meta-analysis was conducted on studies investigating long-term outcome after Rhythmia HDM-guided atrial fibrillation (AF) or atrial tachycardia catheter ablation. Results: Beyond multiple studies providing novel insights into arrhythmia mechanisms, follow-up data from 17 studies analyzing Rhythmia HDM-guided ablation (1768 patients, 49% with previous ablation) were investigated. Cumulative acute success was 100/90.2%, while 12 months long-term pooled success displayed at 71.6/71.2% (AF/atrial tachycardia). Prospective data are limited, showing similar outcome between HDM-guided and conventional AF ablation. Conclusion: Acute results of HDM-guided catheter ablation are promising, while long-term success is challenged by complex arrhythmogenic substrates. Prospective randomized trials investigating different HDM-guided ablation strategies are warranted and underway.
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Alken et al. (2020) conducted a meta-analysis in Atrial fibrillation or atrial tachycardia (n=1,768). Rhythmia HDM-guided catheter ablation vs. Conventional AF ablation was evaluated on 12 months long-term pooled success. Rhythmia HDM-guided catheter ablation demonstrated a 12-month pooled success rate of 71.6% for atrial fibrillation and 71.2% for atrial tachycardia.
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