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2018 AF Symposium Live Case: RADAR―A Software Breakthrough in Identifying A-Fib Rotors and Drivers?

by Steve S. Ryan, PhD

RADAR’ may lead to the next big breakthrough in electro-magnetic imaging analysis software for mapping and ablating A-Fib rotors and drivers.

RADAR Clinical Trial

RADAR stands for Real-Time Electrogram Analysis for Drivers of AtRial Fibrillation.

The RADAR Clinical Trial is a prospective, non-randomized, investigational device exemption (IDE) study evaluating new analysis software in patients undergoing catheter ablation for persistent Atrial Fibrillation. This special software algorithm is made by AFTx, Inc.

A-Fib Pattern Recognition Algorithm

The software employs an A-Fib pattern recognition algorithm which can assess what is happening in a particular location within the heart. Then it geometrically stitches together the whole heart chamber to the highest available contact electrograms which results in a high-density 3-D map of the atrium in A-Fib.

Dr. Vivek Reddy from Mount Sinai, New York City, calls the resulting map a ‘PADA’ (probabilistic atrial driver assessment) map showing rotors and focal impulse areas.

The Live Case Using the AFTx RADAR System

Petr Neuzil, MD

Dr. Reddy introduced Dr. Petr Neuzil from Prague, Czech Republic who performed the live case.

Patient Background: The patient was in paroxysmal A-Fib but had suffered a stroke in November 2017 and was on anticoagulants.

First, a standard PVI was performed. Then the spiral mapping catheter was used to map and ablate non-PV triggers (using the Abbott EnSite Precision™ cardiac mapping system).

The AFTx RADAR system uses a 20-pole spiral multielectrode mapping catheter within the heart. (In contrast, the recently developed ECGi CardioInsight [Medtronic] uses a multielectrode vest to capture ECG far-field signals from the body surface.)

Live Streaming Video from AF Symposium at A-Fib.com

Live Streaming Video at AF Symposium

Lesion Indicators: Green, Blue and Red Dots

While watching the live case, when an effective transmural ablation was completed, a green dot appeared. After several ablation applications, a line appeared to connect the green dots. This apparently made it much easier to assess contiguous lesions.

A blue dot represented the latest ablation point. A red dot indicated a possible non-transmural lesion.

Dr. Neuzil’s surgical team in Prague was still ablating the patient when the time block for the live case ran out.

Editor’s Comments:
Making continuous lesions is critical to an effective ablation. But first the ablation sites must be accurately identified and mapped.
Easier and More Reliable: Not only does the RADAR system produce a very accurate, highest density map of the atrium, but the green dots and the visible line between them makes it much easier and more reliable to assess whether lesions are contiguous (no gaps).
History Being Made? Here is yet another instance where attendees at the AF Symposium 2018 were possibly seeing history being made.
The RADAR system may be the next big breakthrough in mapping and ablating A-Fib rotors and drivers and may be a major advance in the treatment of A-Fib.

If you find any errors on this page, email us. Y Last updated: Sunday, February 25, 2018

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