A comparison between multipolar mapping and conventional mapping of atrial tachycardias in the context of atrial fibrillation ablation

Bun, Sok‐Sithikun; Delassi, T.; Laţcu, Decebal Gabriel; Jamili, Mohamed El; Ayari, Anis; Errahmouni, Abdelkarim; Berte, Benjamin; Saoudi, Nadir

doi:10.1016/j.acvd.2017.04.005

Cited by 17 publications

(15 citation statements)

References 21 publications

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“…However, few studies have compared multipolar with conventional PbyP mapping. Bun et al 23 reported a significant reduction in mapping and ablation times with MPM using the PentaRay for macro (69%) and focal AT following AF ablation. Arrhythmia recurrence was significantly less in the MPM group, however, the historical PbyP control group had all undergone ablation in a time period earlier than the MPM 23 and there was a significant difference in the incidence of focal tachycardias between the groups.…”

Section: Discussionmentioning

confidence: 99%

Multipolar mapping with the high‐density grid catheter compared with conventional point‐by‐point mapping to guide catheter ablation for focal arrhythmias

Chieng

Lahiri

Sugumar

et al. 2020

Cardiovasc electrophysiol

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Background Multipolar catheters provide high‐density mapping which may reduce the procedural duration and improve the success of catheter ablation (CA) for focal arrhythmias. The high‐density grid (HDG) catheter is a 16 electrode mapping catheter with bipole recordings at orthogonal splines. The aim of this study is to compare the clinical and procedural features from a cohort who underwent CA for focal arrhythmias using multipolar mapping (MPM) with age and case‐matched cohort using point‐by‐point (PbyP) mapping. Methods Consecutive patients undergoing CA for focal arrhythmias between October 2018 and January 2020 guided by MPM were compared with PbyP mapping with the ablation catheter over a similar period. Demographics, procedural features, and outcomes were compared. Results A total of 54 patients (27 in MPM vs. 27 in PbyP mapping) underwent CA for 68 focal arrhythmias (26 atrial and 42 ventricular). In the MPM group, the electrogram at the successful site was significantly earlier (39 ± 11 ms) than in the PbyP group (33 ± 7 ms; p = .02). In the MPM group, the mapping time (35 ± 24 vs. 53 ± 31 min in PbyP; p = .03) and procedural duration (126 ± 42 vs. 153 ± 39 min in PbyP; p = .02) were significantly shorter. There was no significant difference in radiofrequency and fluoroscopy times, acute procedural success, and arrhythmia recurrence. Conclusion MPM with the HDG catheter for focal tachycardias identified earlier activation times and was associated with shorter mapping and procedure duration with equivalent success to PbyP mapping.

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Section: Discussionmentioning

confidence: 99%

Multipolar mapping with the high‐density grid catheter compared with conventional point‐by‐point mapping to guide catheter ablation for focal arrhythmias

Chieng

Lahiri

Sugumar

et al. 2020

Cardiovasc electrophysiol

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“…If a higher mapping density was expected with the multipolar catheter, 42 several other results 41 emphasize the importance of smaller size-closely-spaced electrodes when mapping scar-related AT. In these conditions, EGM duration is shorter (by eliminating far-fields and minimizing the mapped area by each point), delineation of lowvoltage areas is improved (abnormal, low-voltage, as well as densescar areas are smaller), late potentials and EGM fractionation are more frequently recorded.…”

Section: Preprocedural Imagingmentioning

confidence: 92%

Scar identification, quantification, and characterization in complex atrial tachycardia: a path to targeted ablation?

et al. 2019

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Successful catheter ablation of scar-related atrial tachycardia depends on correct identification of the critical isthmus. Often, this is a represented by a small bundle of viable conducting tissue within a low-voltage area. It's identification depends on the magnitude of the signal/ noise ratio. Ultra-high density mapping, multipolar catheters with small (eventually unidirectional) and closely-spaced electrodes improves low-voltage electrogram detection. Background noise limitation is also of major importance for improving the signal/noise ratio. Electrophysiological properties of the critical isthmus and the characteristics of the local bipolar electrograms have been recently demonstrated as hallmarks of successful ablation sites in the setting of scar-related atrial tachycardia.

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“…The use of the PentaRay catheter has been demonstrated in a number of case reports and studies of patients with AF. [19,20,34,42,43] In a recent prospective study – Substrate Ablation Guided by High Density Mapping in Atrial Fibrillation (SUBSTRATE HD) (NCT02093949), AF was sequentially mapped in both atria of 105 patients admitted for AF ablation, using the PentaRay catheter. Radiofrequency times and procedure times were shorter with the PentaRay catheter compared with a validation set in which a conventional ablation approach was used.…”

Section: The Multipolar Mapping Catheter As a Tool For Substrate Mappmentioning

confidence: 99%

High-resolution Mapping in Patients with Persistent AF

Andronache

Drca

Viola³

2019

Arrhythm Electrophysiol Rev

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Ablation of AF through electrical isolation of the pulmonary veins is a well-established technique and a cornerstone in the ablation of AF, although there are a variety of techniques and ablation strategies now available. However, high numbers of patients are returning to hospital after ablation procedures such as pulmonary vein isolation (PVI). Scar tissue (as identified by contact voltage mapping) is found to be present in many of these patients, especially those with persistent AF and even those with paroxysmal AF. This scarring is associated with poor outcomes after PVI. Cardiac mapping is necessary to locate triggers and substrate so that an ablation strategy can be optimised. Multipolar mapping catheters offer more information regarding the status of the tissue than standard ablation catheters. A patient-tailored catheter ablation approach, targeting the patient-specific low voltage/fibrotic substrate can lead to improved outcomes.

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A comparison between multipolar mapping and conventional mapping of atrial tachycardias in the context of atrial fibrillation ablation

Abstract: In patients with multiple ATs, multielectrode PentaRay mapping was faster than the conventional technique, with less radiofrequency delivery and a better mid-term outcome.

Cited by 17 publications

References 21 publications

Multipolar mapping with the high‐density grid catheter compared with conventional point‐by‐point mapping to guide catheter ablation for focal arrhythmias

Multipolar mapping with the high‐density grid catheter compared with conventional point‐by‐point mapping to guide catheter ablation for focal arrhythmias

Scar identification, quantification, and characterization in complex atrial tachycardia: a path to targeted ablation?

High-resolution Mapping in Patients with Persistent AF

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