Clin Res Cardiol (2021). 10.1007/s00392-021-01933-9

The novel wide-band dielectric imaging system to guide radiofrequency-based catheter ablation: Feasibility and First Insights
F. Moser1, L. Rottner1, J. Moser1, R. Schleberger1, M. Lemoine1, P. Münkler1, L. Dinshaw1, P. Kirchhof1, B. Reissmann1, F. Ouyang1, A. Metzner1, A. Rillig1
1Klinik für Kardiologie, Universitäres Herz- und Gefäßzentrum Hamburg GmbH, Hamburg;

Background: Pulmonary vein isolation (PVI) is an established rhythm control therapy in patients with atrial fibrillation (AF). Recently, a novel wide-band dielectric imaging system (KODEX-EPD) was introduced into clinical practice. First clinical experience has shown promising results in cryoballoon-based PVI, however the feasibility in radiofrequency (RF)-based procedures as a stand-alone mapping system has not been reported yet.

Aim:  The aim of this study was to evaluate feasibility and acute efficacy of RF-based PVI using solely the novel wide-band dielectric imaging system without concomitant use of other mapping systems. 

Methods: Consecutive patients with AF who underwent PVI in combination with the KODEX-EPD system were analyzed. 3-dimensional maps were created with a circular mapping catheter, isolation of the ipsilateral pulmonary veins (PVs) was performed via point-by-point RF ablation.

Results: A total of 10 patients (6 male (60%), 63 [52, 69], 5 persistent AF (50%)) underwent conventional RF-based PVI with KODEX EPD guidance. Total procedure time was 125 [112, 134] minutes, fluoroscopy time and dosage were 13 [11, 14] minutes and 511 [439, 581] cGycm, respectively. KODEX-EPD map of the left atrium was obtained with a mean of 1755 [1287, 2048] acquired mapping points. All 40 PVs (100%) were successfully isolated. In one patient, where cardioversion was not feasible after PVI only, a left atrial anterior line and posterior box ablation was successfully performed. No peri- or postprocedural complications occurred. 

Conclusion: The novel KODEX-EPD imaging system is feasible to guide RF-based isolation of the PVs.  No periprocedural complications occurred in this study population. Further studies are needed to compare theKODEX-EPD system with established 3D-mapping systems for RF-based ablation.


https://dgk.org/kongress_programme/ht2021/P910.htm