Left atrial voltage mapping with a direction-independent grid catheter: Comparison with a conventional circular mapping catheter.
Action Potentials
Aged
Atrial Fibrillation
/ diagnosis
Atrial Function, Left
Cardiac Catheterization
/ instrumentation
Cardiac Catheters
Catheter Ablation
Electrophysiologic Techniques, Cardiac
/ instrumentation
Equipment Design
Female
Heart Rate
Humans
Male
Middle Aged
Predictive Value of Tests
Pulmonary Veins
/ physiopathology
Recurrence
grid mapping catheter
low-voltage area
voltage map
Journal
Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
14
09
2019
revised:
24
10
2019
accepted:
03
11
2019
pubmed:
9
11
2019
medline:
21
10
2020
entrez:
9
11
2019
Statut:
ppublish
Résumé
A recently introduced grid mapping catheter (GMC) is designed for better electrode-tissue contact and can collect bipolar signals both along and across the splines, which may allow more efficient voltage map generation independent of propagation direction. We compared the GMC with a conventional circular mapping catheter (CMC) for left atrial (LA) voltage mapping. This study included 20 consecutive patients undergoing repeat ablation for recurrent atrial fibrillation who had demonstrated LA low-voltage areas (LVAs, <0.10 mV). Following pulmonary vein isolation, LA voltage mapping was performed twice, once using the GMC and once using the CMC. Voltage mapping was more efficient using the GMC than the CMC in terms of mapping time (459 [404, 543] vs 602 [496, 814] seconds; P = .014) and the number of mapping points (2446 [2099, 3104] vs 1841 [1494, 2314]; P = .002). The incidence of catheter-induced ectopies was lower (44 [28, 62] vs 114 [74, 188]; P < .0001) using the GMC. The GMC utilizing all bipoles detected LVAs in 85% of patients with LVAs detected by CMC. LVA measurements were significantly smaller on maps generated by the GMC using bipoles along or across the splines than those measured with the CMC (11.1 [4.6, 17.2] or 9.7 [2.5, 16.0] vs 16.4 [6.8, 26.8] cm The GMC allowed a more efficient mapping procedure and enabled more selective identification of LVAs with smaller LVA size.
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2834-2840Informations de copyright
© 2019 Wiley Periodicals, Inc.
Références
Rolf S, Kircher S, Arya A, et al. Tailored atrial substrate modification based on low-voltage areas in catheter ablation of atrial fibrillation. Circ Arrhythm Electrophysiol. 2014;7:825-833.
Yang G, Yang B, Wei Y, et al. Catheter ablation of nonparoxysmal atrial fibrillation using electrophysiologically guided substrate modification during sinus rhythm after pulmonary vein isolation. Circ Arrhythm Electrophysiol. 2016;9:e003382. https://doi.org/10.1161/CIRCEP.115.003382
Kottkamp H, Berg J, Bender R, Rieger A, Schreiber D. Box isolation of fibrotic areas (BIFA): a patient-tailored substrate modification approach for ablation of atrial fibrillation: substrate modification BIFA in AF ablation. J Cardiovasc Electrophysiol. 2016;27:22-30.
Jadidi AS, Lehrmann H, Keyl C, et al. Ablation of persistent atrial fibrillation targeting low-voltage areas with selective activation characteristics. Circ Arrhythm Electrophysiol. 2016;9:e002962. https://doi.org/10.1161/CIRCEP.115.002962
Yamaguchi T, Tsuchiya T, Nakahara S, et al. Efficacy of left atrial voltage-based catheter ablation of persistent atrial fibrillation. J Cardiovasc Electrophysiol. 2016;27:1055-1063.
Masuda M, Fujita M, Iida O, et al. Influence of underlying substrate on atrial tachyarrhythmias after pulmonary vein isolation. Heart Rhythm. 2016;13:870-878.
Masuda M, Fujita M, Iida O, et al. Left atrial low-voltage areas predict atrial fibrillation recurrence after catheter ablation in patients with paroxysmal atrial fibrillation. Int J Cardiol. 2018;257:97-101.
Oakes RS, Badger TJ, Kholmovski EG, Akoum N, Burgon NS, Fish EN. Detection and quantification of left atrial structural remodeling with delayed-enhancement magnetic resonance imaging in patients with atrial fibrillation. Circulation. 2009;119:1758-1767.
Ullah W, Hunter RJ, Baker V, et al. Impact of catheter contact force on human left atrial electrogram characteristics in sinus rhythm and atrial fibrillation. Circ Arrhythm Electrophysiol. 2015;8:1030-1039.
Yeo C, Tan VH, Wong KCK. Pulmonary vein reconnection mapping with Advisor HD Grid demonstrating local EGM which were not visible on Tacticath ablation catheter. J Arrhythm. 2019;35:152-154.
Masuda M, Asai M, Iida O, et al. Comparison of electrogram waveforms between a multielectrode mapping catheter and a linear ablation catheter. Pacing Clin Electrophysiol. 2019;42:515-520.
Anter E, Tschabrunn CM, Josephson ME. High-resolution mapping of scar-related atrial arrhythmias using smaller electrodes with closer interelectrode spacing. Circ Arrhythm Electrophysiol. 2015;8:537-545.
Huemer M, Qaiyumi D, Attanasio P, et al. Does the extent of left atrial arrhythmogenic substrate depend on the electroanatomical mapping technique: impact of pulmonary vein mapping catheter vs. ablation catheter. Europace. 2017;19:1293-1301.