Grid‐mapping catheters versus PentaRay catheters for left atrial mapping on ensite precision mapping system

Abstract

Introduction: Areas displaying reduced bipolar voltage are defined as low-voltage areas (LVAs). Moreover, left atrial (LA) LVAs after pulmonary vein isolation (PVI) have been reported as a predictor of recurrent atrial fibrillation (AF). In this study, we compared grid mapping catheter (GMC) with PentaRay catheter (PC) for LA voltage mapping on Ensite Precision mapping system.Methods: Twenty-six consecutive patients with LVAs and border zone within the LA were enrolled. After achieving PVI, voltage mapping under high right atrial pacing for 600 ms was performed twice using each catheter type (GMC first, PC next).Furthermore, LVA was defined as a region with a bipolar voltage of <0.50, and border zone was defined as a region with a bipolar voltage of <1.0, or <1.5 mV.Results: Compared with PC, using GMC, voltage mapping contained more mapping points (20 242 [15 859, 26 013] vs. 5589 [4088, 7649]; p < .0001), and more mapping points per minute (1428 [1275, 1803] vs. 558 [372, 783]; p < .0001). In addition, LVA and border zone size using GMC was significantly less than that reported using PC: <1.0 mV (5.9 cm 2 [2.9, 20.2] vs. 13.9 cm 2 [6.3, 24.1], p = .018) and <1.5 mV voltage cutoff (10.6 cm 2 [6.6, 27.2] vs. 21.6 cm 2 [12.6, 35.0], p = .005). Conclusion:Bipolar voltage amplitude estimated by GMC was significantly larger than that estimated by PC on Ensite Precision mapping system. GMC may be able to find highly selective identification of LVAs with lower prevalence and smaller LVA and border zone size.

Baseline left atrial low-voltage area predicts recurrence after pulmonary vein isolation: WAVE-MAP AF results

“… 5 Saito et al . 23 also revealed that bipolar voltage amplitude estimated by Advisor HD Grid was significantly larger than PentaRay catheter. Similarly, smaller LVAs were seen using Advisor HD Grid when compared with either linear duodecapolar catheter 24 or CMC maps in the same patients.…”

Left Atrial Electrophysiological Properties after Pulmonary Vein Isolation Predict the Recurrence of Atrial Fibrillation: A Cohort Study

“…Compared with coronary sinus pacing, the average amplitude during sinus rhythm was significantly higher, indicating the directional dependence of amplitude of bipolar signal [ 38 ]. Additionally, factors such as electrode spacing and size, degree of tissue contact, signal filtering (references selected), and number of mapping points can also affect the mapping results for LVA [ 39 ]. These could explain some of the discordant results between studies.…”

Angiotensin receptor-neprilysin inhibitor therapy and recurrence of atrial fibrillation after radiofrequency catheter ablation: A propensity-matched cohort study

“…In our study, the mapping catheters we used were LASSO electrodes, which have relatively few mapping points, low mapping density, cannot be automatically mapped, and usually required manual correction. In recent years, many high-density and ultra-high-density mapping electrodes, such as PentaRay catheters, Orion catheters, and HD Grid catheters have been developed, and some are currently used in clinical applications ( 53 , 54 ). The Orion basket electrodes had high electrode density, with a total of 64 electrodes located in 8 basket branches.…”