Author + information
- Received February 22, 2019
- Revision received June 24, 2019
- Accepted June 25, 2019
- Published online August 28, 2019.
- Tilman Maurer, MDa,∗ (, )
- Shibu Mathew, MDa,
- Michael Schlüter, PhDb,
- Christine Lemes, MDa,
- Johannes Riedl, MDa,
- Osamu Inaba, MDa,
- Naotaka Hashiguchi, MDa,
- Bruno Reißmann, MDa,
- Thomas Fink, MDa,
- Laura Rottner, MDa,
- Andreas Rillig, MDa,
- Andreas Metzner, MDa,
- Feifan Ouyang, MDa and
- Karl-Heinz Kuck, MDa
- aDepartment of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
- bAsklepios Proresearch, Hamburg, Germany
- ↵∗Address for correspondence:
Dr. Tilman Maurer, Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099 Hamburg, Germany.
Objectives This study presents the first report of high-resolution imaging of cardiac anatomy using a novel system.
Background Recently, the wide-band dielectric mapping system Kodex was introduced.
Methods This study included 20 consecutive patients with symptomatic atrial fibrillation or left atrial tachycardia who were scheduled for an ablation procedure and who underwent simultaneous left atrial mapping using the Kodex and CARTO 3 systems. Pulmonary vein angiograms served as a reference to compare the craniocaudal dimensions of the pulmonary vein ostia as depicted by either of the 2 mapping systems.
Results Complete left atrial imaging was achieved within a median [first quartile; third quartile] of 9.7 [7.5; 12.8] min. Median procedure time was 97.5 [90; 112.5] min, and median total fluoroscopy time was 8.2 [5.7, 10.6] min, of which a median of 1.4 [1.1; 2.3] min were used during the creation of the left atrial map. High-resolution representations of left atrial anatomy were successfully created in all patients. Both the Kodex and CARTO measurements correlated well with fluoroscopy measurements, as reflected by Pearson’s correlation coefficients (r) of 0.91 and 0.95, respectively. Bland-Altman plots revealed that, on average, Kodex measurements underestimated fluoroscopy measurements by 0.04 mm (95% limits of agreement of –5.72 and 5.64 mm), and CARTO measurements underestimated fluoroscopy measurements by 0.02 mm (95% limits of agreement of –3.61 and 3.57 mm).
Conclusions Anatomic mapping of the left atrium using Kodex shows the potential to create computed tomography–like images without the need for additional periprocedural imaging.
Dr. Maurer has received speaker honoraria and travel grants from EPD Solutions/Philips. Dr. Kuck has received research grants and is a consultant to EPD Solutions/Philips; and has served as a consultant for Medtronic, Edwards Lifesciences, Boston Scientific, Biosense Webster, and St. Jude Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received February 22, 2019.
- Revision received June 24, 2019.
- Accepted June 25, 2019.
- 2019 American College of Cardiology Foundation
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