The LocaLisa system as the key to shortening the procedure duration and fluoroscopy time during ablation of atrial fibrillation.

BACKGROUND Ablation of atrial fibrillation (AF) can be difficult and time-consuming. Systems facilitating catheter navigation may be helpful. AIM To compare the efficacy of the LocaLisa system with the conventional mapping/ablation approach to radiofrequency (RF) ablation of AF. METHODS Group 1, consisting of 64 patients (48 male; aged 51.5+/-10.6 years), underwent segmental isolation of the pulmonary veins with the Lasso catheter and the LocaLisa system. Group 2, consisting of 64 patients (44 male, aged 51.4+/-11.0 years), had RF ablation guided by means of a conventional fluoroscopy-based approach. Clinical and procedural data were analysed. RESULTS Nine patients from group 1 and three patients from group 2 had persistent AF. In group 1 the mean number of isolated veins was 3.98+/-0.96, while in group 2 - 4.0+/-0.95 (NS). In group 1 cavotricuspid isthmus lines were created in four patients and lines in the roof of the left atrium in two patients. One patient needed slow pathway ablation. In group 2 six patients had ablation of the cavotricuspid isthmus and a line was created at the roof of the left atrium in one patient. Two patients had ectopic activity ablated in the crista terminalis. Procedure times were 131.6+/-40.3 and 170.0+/-56.5 min (p <0.0001) and fluoroscopy times were 16.93+/-9.7 and 35.66+/-12.7 min (p <0.0001) for groups 1 and 2, respectively. Long-term efficacy of RF ablation was similar in both groups (for example, complete success was achieved in 59% of patients using LocaLisa and 50% without using this system, NS). CONCLUSIONS The LocaLisa navigation system makes it possible to shorten both the duration of the procedure and the total fluoroscopy time during ablation of AF.