Evaluation of a novel high-resolution mapping system for catheter ablation of ventricular arrhythmias

Substrate characterization and catheter ablation in patients with scar‐related ventricular tachycardia using ultra high‐density 3‐D mapping

“…Mapping during VT is frequently impossible due to noninducibility or hemodynamic instability, thus accurate substrate characterization with high spatial resolution is of importance. Our experience regarding the feasibility of ventricular mapping using the novel basket catheter and related underlying annotation algorithms is in line with the recently published first case series on this new mapping catheter and system . The acquired mapping points in the present study exceed the usual amount gained by established 3‐D mapping systems by far and information on the underlying morphological and functional substrate could be obtained simultaneously.…”

“…The extent of ventricular low voltage was measured using the measuring tool within the mapping system. For scar demarcation, a bipolar endocardial voltage of 0.1 to 1 mV (dense scar <0.1 mV, border zone 0.1–1.0 mV, healthy tissue >1.0 mV) and a unipolar endocardial voltage of <4.5 mV (in line with previous studies, no further division into dense/border zone scar was done regarding unipolar voltage) were chosen (Table ). Epicardial voltage thresholds were the same for bipolar voltage and <6.0 mV for unipolar voltage (Fig.…”

“…Recently, a novel ultra high‐density 3‐D mapping system consisting of a 64‐pole mini‐basket catheter with relatively small electrode size and spacing and an adjunctive mapping system have been introduced (Rhythmia TM , Boston Scientific, Marlborough, MA, USA). There is only limited experience in ventricular procedures and so far only one case series has been described . Moreover, ventricular voltage thresholds are not yet defined in humans.…”

Ultra-fast, high density 3D mapping (Rhythmia Mapping System) and catheter radiofrequency ablation for electrical storm – early single centre experience

“…Viswanathan et al showed that with the Rhythmia Mapping System the operator was able to create 25 VT maps in 19 patients, including 7 maps with >90% activation captured. (16) Similarly, we have shown that Rhythmia allows one to make a map during VT in a substantial proportion of ES patients, being significantly greater than with Carto. Although this feature did not translate into a higher success rate in our patients, one has to keep in mind that these are preliminary findings only.…”

Novel automated point collection software facilitates rapid, high‐density electroanatomical mapping with multiple catheter types

“…Non‐contact mapping allows for rapid chamber mapping, but can be associated with spatial artifacts, and is not in common clinical use . Contact mapping with multielectrode catheters that allow for collection of multiple points in space simultaneously have been described . Although previously described multielectrode catheters can facilitate rapid point collection, these catheters are sometimes bulky and may not be applicable to all mapping and ablation situations.…”