Multipolar mapping (MPM) has primarily been studied in complex arrhythmia substrates or reentrant circuits. Chieng et al. use a case-control design to compare MPM and point-by-point mapping with an ablation catheter for focal atrial and ventricular tachycardias, showing reduced procedure times and earlier electrograms in the MPM group but no difference in clinical outcomes. It is plausible that faster mapping and better delineation of earliest signals may translate to improved clinical outcomes if studied in a randomized trial in a larger population. Future MPM systems will guide the operator toward the focus in real-time and may even triangulate the source in three dimensions, giving an estimate of depth within the myocardium or likely focus in the opposite chamber.
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Introduction: Differences in predictability of ablation success for premature ventricular contractions (PVCs) between earliest isochronal map area (EIA), local activation time (LAT) differences on unipolar and bipolar electrograms (⊿LAT), LAT prematurity on bipolar electrograms (LAT), and unipolar morphology of QS or Q pattern remain unclear. We verified multiple statistical predictabilities of those indicators of ablation success on mapped cardiac surface.
Methods: Thirty-five patients with multiple PVCs underwent catheter ablation after LAT mapping using multipolar mapping catheters with unipolar-based annotation.
High-density electroanatomic mapping of atriofascicular pathways using multipolar mapping catheters can identify oblique pathways and avoid mechanical bump termination.
Heart Rhythm
November 2024
Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA.
Background: Atriofascicular fibers (AFFs) are rare accessory pathways that have higher rates of recurrence after ablation because of either failure to identify AFF (M) potentials or mechanical termination with contact.
Objective: We aimed to evaluate whether electroanatomic mapping (EAM) using multielectrode, high-density nonlinear catheters can reliably localize AFF potentials and determine a site for ablation without causing mechanical termination.
Methods: Seven patients underwent electrophysiology studies (EPS) and EAM using high-density, multielectrode catheters for antidromic tachycardia using AFFs.
Unipolar voltage electroanatomic mapping detects structural atrial remodeling identified by LGE-MRI.
Heart Rhythm
October 2024
Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland; Alliance for Cardiovascular Diagnostic and Treatment Innovation, Johns Hopkins University, Baltimore, Maryland. Electronic address:
Background: In atrial fibrillation (AF) management, understanding left atrial (LA) substrate is crucial. While both electroanatomic mapping (EAM) and late gadolinium enhancement magnetic resonance imaging (LGE-MRI) are accepted methods for assessing the atrial substrate and are associated with ablation outcome, recent findings have highlighted discrepancies between low-voltage areas (LVAs) in EAM and LGE areas.
Objective: The purpose of this study was to explore the relationship between LGE regions and unipolar and bipolar LVAs using multipolar high-density mapping.
High-Power Short-Duration Posterior Wall Isolation in Addition to Pulmonary Vein Isolation in Persistent Atrial Fibrillation Ablation Using the New TactiFlex™ Ablation Catheter.
J Cardiovasc Dev Dis
September 2024
Department of Electrophysiology, ARNAS Civico-Di Cristina-Benfratelli, 90127 Palermo, Italy.
Article Synopsis
- The study evaluates the safety and effectiveness of the TactiFlex™ ablation catheter for treating persistent atrial fibrillation (Pe-AF) through pulmonary vein isolation (PVI) and posterior wall isolation (PWI), involving high-power short-duration (HPSD) RF ablations.
- Conducted between February 2023 and February 2024, the study included 52 patients who received ablation, achieving high success rates for PVI and PWI without significant differences compared to a historical cohort using a different ablation catheter.
- The TactiFlex™ group demonstrated shorter procedural and RF times, with minimal PV reconnections observed after adenosine administration, highlighting its potential effectiveness in treating Pe-AF.
Pulsed-field- vs. cryoballoon-based pulmonary vein isolation: lessons from repeat procedures.
Europace
August 2024
Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Aims: Pulsed-field ablation (PFA) is an emerging technology to perform pulmonary vein isolation (PVI). Initial data demonstrated high safety and efficacy. Data on long-term PVI durability and reconduction patterns in comparison to established energy sources for PVI are scarce.
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