“It's really amazing. The system is intuitive, smart and simple,” he said.“The physician can insert one catheter (Sphere 9) just one time. It can map, ablate with either radio frequency (RF) or pulsed field ablation (PFA), and verify that we either got it right or have to ablate further. Other systems have to remove the catheter and put in another one for each of those steps. The Affera system is an incredible step forward.”

What do mappers do?

Today, his days start around 7:00 A.M. at Vanderbilt University Medical Center in Nashville. Staff prepares the electrophysiology lab while Stalls sets up his mapping equipment. The first patient is typically in the room by 7:30 A.M.

“Sometimes they ask questions and I can say 'I've been in your shoes,' and I can share with patients how ablation helped me,” Stalls said.“It's a nice feeling to be able to help them that way.”

The procedure begins. The electrophysiologist (EP) inserts a catheter into the patient's groin, navigates it into the heart and they begin“mapping.” Electrodes on the catheter measure the voltage and the electrical activation time on all the tissue they touch, creating a 3D image of the heart's electrical activity in a rainbow of bright colors.“Each color tells us something. Purple means healthy tissue. Red means not so healthy. And a lot of things in between,” Stalls said.

The EP and mapper work together during the case while the EP identifies spots that require ablation. The procedure can take 45 to 60 minutes, with constant communication back and forth between the EP, the mapper and other members of the team. It's a relationship built on experience and trust.

“Mappers usually work with a lot of different physicians,” said Dr. Lan.“So they see different techniques and bring that experience to provide the technical knowledge, supporting every physician to treat our patients. There's a lot of teamwork.”

“The mapper needs to know electrophysiology and the mapping technology inside and out,” Stalls added.“Our job is to advise and consult and focus exclusively on the mapping and ablating technology. Sometimes I'll see things the EPs don't because they have to pay attention to several other things during the procedure.”

Hospitals are moving so quickly to the Affera system that some have the technology in place but not enough mappers to operate them. So experienced mappers sometimes travel to fill the void until hundreds of new, permanent mappers come online. Stalls mapped at hospitals in New York, Chicago, Cleveland, Austin, TX and Milwaukee in the last few months. No matter where he goes, he still keeps images from the mapping of his own heart on his phone-a regular reminder of where he's been, and what's ahead.

“I'm just really grateful,” he said.“I felt cursed by Afib but it's turned out to be a blessing. When a patient comes in with Afib and leaves in normal rhythm, it's just incredibly rewarding to be a part of something like that.”

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Important Safety Information

Risks may include serious complications and injuries to cardiac and other body structures. The Sphere-9TM catheter and AfferaTM mapping and ablation system, PulseSelectTM pulsed field ablation system, and Arctic Front AdvanceTM over-the-wire balloon catheter should only be used under the supervision of a physician that performs cardiac ablation procedures.