Key result
Left bundle branch ablation guided by the NavX system significantly reduced procedure time (1.7 vs 2.4 hours, P=0.015) and X-ray exposure (0.2 vs 0.5 hours, P<0.001) compared to fluoroscopy.
Why the study?
Does left bundle branch ablation guided by LBP and a 3D mapping system reduce procedure and X-ray exposure times compared to fluoroscopy guidance in canine models?
Does left bundle branch ablation guided by LBP and a 3D mapping system reduce procedure and X-ray exposure times compared to fluoroscopy guidance in canine models?
Absolute Event Rate: 1.7% vs 2.4%
p-value: p=0.015
The use of a 3D electroanatomical mapping system to guide left bundle branch ablation in canine models is feasible and significantly reduces both procedure and fluoroscopy times compared to conventional fluoroscopy.
Supports 3D mapping feasibility in canine models; leaves open translation to human left bundle branch procedures.
Introduction: The purpose of this study was to evaluate the feasibility of left bundle ablation guided by left bundle potential (LBP) and three dimensional mapping system (EnSite NavX system) in canine models. Methods and Results: The canines were sequentially allocated into two groups, left bundle branch ablation guided by LBP and either fluoroscopy or NavX system. An LBP (mean LBP-V 17.8 ? 2.6 ms; 13-21) was identified resulting in successful left bundle ablation in 9 dogs. The A:V electrogram ratio at the successful LBP ablation site was <1:10 in all 9 dogs successfully ablated. In two dogs, a similar potential (potential-V 24 or 28 ms, respectively) were identified, but radiofrequency energy application produced high degree or complete atrioventricular (AV) block. Left bundle branch ablation failed in the first three dogs. The procedure time and X-ray exposure time were significantly reduced in the group guided by LBP and NavX system compared with those by LBP and X-ray imaging (2.4 ? 0.3 Vs. 1.7 ? 0.3 hours, P=0.015; 0.5 ? 0.07 Vs. 0.2 ? 0.02 hours, P0.001, respectively). Conclusions: Selective transcatheter left bundle ablation was successfully guided by the LBP and NavX system. Compared with the
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Ding Ligang Yin Kang (2015) studied Left bundle branch ablation (n=14). Left bundle branch ablation guided by LBP and NavX system vs. Left bundle branch ablation guided by LBP and fluoroscopy was evaluated on Procedure time (hours) (p=0.015). Left bundle branch ablation guided by the NavX system significantly reduced procedure time (1.7 vs 2.4 hours, P=0.015) and X-ray exposure (0.2 vs 0.5 hours, P<0.001) compared to fluoroscopy.
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