C17 - Feasibility and Safety of High-resolution Three-dimensional Electroanatomical Mapping of the Complete Heart in Dogs

Abstract: Background – Three-dimensional electroanatomical mapping (3D EAM) has expanded radiofrequency catheter ablation (RFCA) applications in humans to almost all complex arrhythmias and has drastically reduced fluoroscopy use, yet its potential in dogs is poorly investigated.

Objectives – To assess the feasibility and safety of 3D EAM of all four heart chambers in dogs using minimal fluoroscopy.

Animals – Eight Beagles (median weight 12.2 kg (11.2-15.7)).

Methods – Prospective experimental trial. Three-dimensional EAM was attempted during sinus rhythm under general anesthesia using a 22-electrode mapping catheter and CARTO 3 system. Left heart catheterization was achieved by retrograde transaortic access (n = 4) or transseptal puncture (TSP) (n = 4). Primary outcomes included feasibility, safety and fluoroscopy time.

Results – Successful 3D EAM of the right atrium and ventricle was achieved in all dogs. Left atrial and ventricular 3D EAM was achieved in six and seven dogs respectively. Median fluoroscopy time was 6.8 min (0.0-45.1) and almost exclusively associated with TSP. Complications requiring intervention occurred in one dog only and were a transient third degree atrioventricular block after interatrial septum engagement, which reversed after intracardiac pacing (10.3 min), and development of pericardial effusion following TSP treated by pericardiocentesis. Peri-operative self-limiting arrhythmias were frequently observed. Only two dogs received lidocaine to resolve intra-operative ventricular tachycardia.

Conclusions and clinical importance – Three-dimensional EAM of all cardiac chambers is feasible, requires minimal fluoroscopic assistance and is promising to guide RFCA of arrhythmias in dogs. Complications were mainly related to TSP and similar to those reported in people.