A novel octaray multielectrode catheter for high‐resolution atrial mapping: Electrogram characterization and utility for mapping ablation gaps

Abstract

Introduction Multielectrode mapping catheters improve the ability to map within the heterogeneous scar. A novel Octaray catheter with eight spines and 48 electrodes may further improve the speed and resolution of atrial mapping. The aims of this study were to (1) establish the Octaray's baseline mapping performance and electrogram (EGM) characteristics in healthy atria and to (2) determine its utility for identifying gaps in a swine model of atrial ablation lines. Methods and Results The right atria of eight healthy swine were mapped with Octaray and Pentaray catheters (Biosense Webster, Irvine, CA) before and after the creation of ablation lines with intentional gaps. Baseline mapping characteristics including EGM amplitude, duration, number of EGMs, and mapping time were compared. Postablation maps were created and EGM characteristics of continuous lines and gaps were correlated with pathology. Compared with Pentaray, the Octaray collected more EGMs per map (2178 ± 637 vs 1046 ± 238; P < 0.001) at a shorter mapping duration (3.2 ± 0.79 vs 6.9 ± 2.67 minutes; P < 0.001). In healthy atria, the Octaray recorded lower bipolar voltage amplitude (1.96 ± 1.83 mV vs 2.41 ± 1.92 mV; P < 0.001) while ablation gaps were characterized by higher voltage amplitude (1.24 ± 1.12 mV vs 1.04 ± 1.27 mV; P < 0.001). Ablation gaps were similarly identified by both catheters (P = 1.0). The frequency of “false gaps,” defined as intact ablation lines with increased voltage amplitude was more common with Pentaray (6 vs 2) and resulted from erroneous annotation of far‐field EGMs. Conclusion The Octaray increases the mapping speed and density compared with the Pentaray catheter. It is as sensitive for identifying ablation gaps and more specific for mapping intact ablation lines.

Spatial-Temporal Signals and Clinical Indices in Electrocardiographic Imaging (II): Electrogram Clustering and T-Wave Alternans

“…These findings are very basic from a signal processing and from a machine learning viewpoint, but show that simple algorithms accounting for spatial information can be useful. Whereas this holds for ECGI systems, where epicardial EGM estimations are provided for a variety of nodes, its translation to current intracardiac navigation systems could be not so straightforward, specially for those ones based on sequential data acquisition, as they usually require additional quality control in terms of the recorded EGMs even with recent multi-catheter electrodes [38][39][40].…”

Procedural Feasibility and Long-Term Efficacy of Catheter Ablation of Atypical Atrial Flutters in a Wide Spectrum of Heart Diseases: An Updated Clinical Overview

“…However, to avoid any misleading interpretation of the underlying circuit, accurate and high-density mapping of investigated atrial chambers is required to account for almost 90% of the tachycardia cycle length and thereby avoiding missing mapping segments potentially due to non-annotated low-amplitude and fragmented electrograms as low as 0.03–0.05 mV [ 27 ]. In this setting, the recent development of new tools, such as Octaray TM system (Biosense Webster Inc., Irvine, CA, USA) and the Ensite TM Omnipolar Technology (OT) (Abbott, Chicago, IL, USA) might allow for even better results [ 62 , 63 , 64 ], provided that the multitude of signals collected is correctly acquired and interpreted.…”

The use of a multipolar diagnostic electrodes in catheter treatment of atrial fibrillation

“…Аблационные разрывы были одинаково идентифицированы обоими катетерами (р = 1,0). Частота «ложных зазоров», определявшаяся как несостоятельные аблационные линии с увеличенной амплитудой напряжения, была более высокой у PentaRay (6 против 2) и являлась результатом ошибочного анализа электрограмм в дальнем поле [28].…”