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PO-FPI-306 AN INTEGRATED MAPPING SYSTEM IMPROVES PROCEDURAL EFFICIENCY AND REDUCES FLUOROSCOPY IN THE DISRUPT-AF REGISTRY
Abstract   Peer reviewed

PO-FPI-306 AN INTEGRATED MAPPING SYSTEM IMPROVES PROCEDURAL EFFICIENCY AND REDUCES FLUOROSCOPY IN THE DISRUPT-AF REGISTRY

Anil Rajendra, Devi G. Nair, Saumil R. Oza, John D. Day, John Costello, Frank A. Cuoco, Anish K. Amin, Steven J. Bailin, Amr F. Barakat, Gustavo X. Morales, …
Heart rhythm, Vol.23(4 Supplement), pp.S115-S116
04/2026
DOI: 10.1016/j.hrthm.2026.03.348

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Abstract

Background Electroanatomical mapping (EAM) is central to most pulsed field ablation (PFA) workflows, offering insights into anatomy, substrate complexity, and lesion placement. Traditional non-integrated, EAM workflows rely on dedicated mapping catheters and multiple exchanges, adding procedural complexity and risk. Alternatively, integrated single-catheter map-and-ablate solutions are designed to streamline PFA workflows, but real-world evidence of their comparative effectiveness remains limited. Objective Describe and quantify procedural characteristics associated with different mapping systems in real-world PFA workflows. Methods DISRUPT-AF (NCT06335082) is a prospective, multicenter registry evaluating use of the pentaspline PFA system. Operators self-reported data, and all procedures adhered to standard care. This analysis included patients with persistent AF undergoing de novo ablation; mapping workflows and cases were stratified based on the EAM system that was used. Results Among 4,559 DISRUPT-AF registry cases (April 2024–November 2025), this sub-analysis included 1,802 patients with persistent AF and mapping data (mean age 70.2±9.8 years; 33.1% female). Integrated map-and-ablate workflows (Opal + Faraview) were associated with fewer catheter exchanges (0.4±0.6 exchanges vs. Opal: 0.7±0.9, Carto: 2.1±1.7, EnSite: 1.1±1.0, No EAM: 0.1±0.4), reduced use of dedicated mapping catheters (0.1±0.3 mapping catheters vs. 0.5±0.5, 1.1±0.3, 0.8±0.4, 0.0±0.0), shorter left atrial dwell time (31.9±10.3 min vs. 44.5±22.7, 43.4±20.9, 36.1±12.0, 24.2±8.2), and lower fluoroscopy exposure (3.7±7.5 min vs. 7.1±7.6, 6.7±21.8, 7.4±7.1, 7.9±4.3) compared with non-integrated mapping workflows. Safety events, acute procedural success, and 3-month recurrence rates were similar across groups (Table 1). Conclusion In this real-world registry, workflows using a navigation-enabled pentaspline PFA catheter with integrated mapping and ablating capabilities were associated with greater procedural efficiency compared with non-integrated electroanatomical mapping systems, without compromising safety or short-term outcomes. Longer follow-up is needed to confirm these findings.

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