Use of a real-time three-dimensional magnetic navigation system for radiofrequency ablation of accessory pathways

Using conventional technology, accessory pathway ablation often requires prolonged exposure of the team and patient to ionizing radiation. Further, although the primary success rate (approximately 90%) and the rate of recurrence (approximately 10%) are acceptable, there is room for improvement. Finally, inadvertent ablation of the compact node and AV/His-Purkinje system still occurs particularly with septal accessory pathways. The Biosense CARTO Nonfluoroscopic Mapping and Navigation System (CARTO System) when used to locate the accessory pathway and guide delivery of radio frequency energy to the accessory pathway, has the potential to reduce radiation exposure, improve primary ablation success, and reduce the rate of recurrence and improve safety. This article describes our experience with the CARTO Biosense System relating to setting up the CARTO System specifically for WPW mapping/ablation, and features of the CARTO System, which are particularly advantageous for mapping and ablation of accessory pathways.