Enhanced ventricular tachycardia substrate resolution with a novel omnipolar high-density mapping catheter: the omnimapping study

Proietti, Riccardo; Adlan, Ahmed; Dowd, Rory; Assadullah, Shershah; Aldhoon, Bashar; Panikker, Sandeep; Foster, Will; Yusuf, Salim; Hayat, Sajad; Osman, Faizel; Banerjee, Prithwish; Dhanjal, Tarvinder

doi:10.1007/s10840-019-00625-9

Cited by 19 publications

(26 citation statements)

References 19 publications

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“…Prior clinical studies have demonstrated the role of MPM catheters for the treatment of atrial and ventricular arrhythmias in the presence of structural heart disease 19–22 . However, few studies have compared multipolar with conventional PbyP mapping.…”

Section: Discussionmentioning

confidence: 99%

“…A novel feature of the HDG catheter is an ability to create bipolar EGMs at orthogonal directions to account for the direction of wavefront propagation 4 . Previous studies have shown that the electrode orientation in relation to wavefront activation is in part responsible for the bipolar EGM 21,26 . If wavefront propagation is orthogonal to the orientation of the bipole it may be subject to a cancellation effect 27 .…”

Section: Discussionmentioning

confidence: 99%

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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%

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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“…However, in vivo, activation occurs in 3D, and it is unlikely that this scenario is relevant in clinical cases (isoelectric EGM without an intrinsic amplitude). 25 Additionally, repeated sampling in a region of interest also overcomes this limitation, as the catheter orientation varies with each manipulation, increasing the probability of detecting a larger local EGM.…”

Section: Bipole Orientationmentioning

confidence: 99%

Impact of Micro-, Mini- and Multi-Electrode Mapping on Ventricular Substrate Characterisation

Berte

Zeppenfeld

Tung

2020

Arrhythm Electrophysiol Rev

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Accurate substrate characterisation may improve the evolving understanding and treatment of cardiac arrhythmias. During substrate-based ablation techniques, wide practice variations exist with mapping via dedicated multi-electrode catheter or conventional ablation catheters. Recently, newer ablation catheter technology with embedded mapping electrodes have been introduced. This article focuses on the general misconceptions of voltage mapping and more specific differences in unipolar and bipolar signal morphology, field of view, signal-to-noise ratio, mapping capabilities (density and resolution), catheter-specific voltage thresholds and impact of micro-, mini- and multi-electrodes for substrate mapping. Efficiency and cost-effectiveness of different catheter types are discussed. Increasing sampling density with smaller electrodes allows for higher resolution with a greater likelihood to record near-field electrical information. These advances may help to further improve our mechanistic understanding of the correlation between substrate and ventricular tachycardia, as well as macro-reentry arrhythmia in humans.

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“…This provides a more efficient point acquisition and greater VT substrate definition of the scar BZ so facilitating conduction channel identification and quantification, which are both important surrogates for ablation strategy. 16 Our group has subsequently shown that VT mapping with the HD GRID has a significant positive impact on the long-term outcomes of VT ablation (paper in press).…”

Section: Introductionmentioning

confidence: 99%

“…Accordingly, a wide range of substrate ablation strategies have been developed over the years from scar homogenization to scar dechanneling or core isolation. Many of these topics have been the focus of a number of prior reviews, some published by our group 15,16 …”

Section: Introductionmentioning

confidence: 99%

The challenge of optimising ablation lesions in catheter ablation of ventricular tachycardia

Proietti

Lichelli

Lellouche

et al. 2020

Journal of Arrhythmia

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Over the last decade, radiofrequency catheter ablation (RFCA) has become an established treatment for ventricular arrhythmias (VA). The recent international consensus report supports RFCA as a first-line therapy for VA in normal heart Ventricular Tachycardia (VT) and in structural heart VT after ineffective anti-arrhythmic drug (AAD) therapy. 1 Several groups have taken this further, proposing prophylactic VT ablation before implantable cardiac defibrillator (ICD) insertion; however this remains an area of debate. 2 Though

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Enhanced ventricular tachycardia substrate resolution with a novel omnipolar high-density mapping catheter: the omnimapping study

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Cited by 19 publications

References 19 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

Impact of Micro-, Mini- and Multi-Electrode Mapping on Ventricular Substrate Characterisation

The challenge of optimising ablation lesions in catheter ablation of ventricular tachycardia

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