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Journal of Interventional Cardiac Electrophysiology

, Volume 55, Issue 3, pp 287–295 | Cite as

The use of a high-resolution mapping system may facilitate standard clinical practice in VE and VT ablation

  • Arian Sultan
  • Barbara BellmannEmail author
  • Jakob Lüker
  • Tobias Plenge
  • Jan-Hendrik van den Bruck
  • Karlo Filipovic
  • Susanne Erlhöfer
  • Liz Kuffer
  • Zeynep Arica
  • Daniel Steven
Article
  • 130 Downloads

Abstract

Background

First experiences using a 64-electrode mini-basket catheter (BC) paired with an automatic mapping system (Rhythmia™) for catheter ablation (CA) of ventricular ectopy (VE) and ventricular tachycardia (VT) have been reported.

Objectives

We aimed to evaluate (1) differences in ventricular access for the BC and (2) benefit of this technology in the setting of standard clinical practice.

Methods

Patients (pts) undergoing CA for VE or VT using the Intellamap Orion™ paired with the Rhythmia™ automated-mapping system were included in this study. For LV access, transseptal and retrograde access were compared.

Results

All 32 pts (29 men, age 63 ± 15 years) underwent CA for VE (17 pts) or VT (15 pts). For mapping of VE originating from the left ventricle (LV) in 10 out of 13 pts, a transaortic access was feasible. The predominant access for CA of VT was transaortic (5/7). Feasibility and safety seem to be equal. The total procedure time was 179.1 ± 21.2 min for VE ablation and 212.0 ± 71.7 min for VT ablation (p = 0.177). For VE, an acquisition of 1602 ± 1672 map points and annotation of 140 ± 98 automated mapping points sufficed to abolish VE in all pts. During a 6-month follow-up (FU) after CA for VE, a VE burden reduction from 18.5 ± 2.1% to 2.8 ± 2.2% (p = 0.019) was achieved. In VT pts, one patient showed recurrence of sustained VT episodes during FU.

Conclusion

Use of a high-resolution mapping system for VE/VT CA potentially facilitates revelation of VE origin and VT circuits in the setting of standard clinical practice. Feasibility and safety of a venous, transaortic, transseptal, or a combined approach seem to be equal.

Keywords

Ablation High-resolution mapping Ventricular tachycardia Ventricular ectopy 

Abbreviation list

CA

Catheter ablation

VT

Ventricular tachycardia

VE

Ventricular ectopy

BC

Mini-basket catheter

LVEF

Left ventricular ejection fraction

ICD

Internal cardioverter defibrillator

LV

Left ventricle

RV

Right ventricle

RF

Radiofrequency

PVS

Programmed ventricular stimulation

FU

Follow up

AECG

Automated electrograms

AAD

Antiarrhythmic drug therapy

CHF

Congestive heart failure

Notes

Author contributions

Arian Sultan, MD: concept/design, data analysis/interpretation, drafting article, statistics, data collection.

Barbara Bellmann, MD: concept/design, data analysis/interpretation, drafting article, statistics, data collection.

Jakob Lüker, MD: data analysis/interpretation, critical revision of article, data collection.

Tobias Plenge, MD: critical revision of article, data collection.

Jan-Hendrik van den Bruck: critical revision of article, data collection.

Karlo Filipovic, MD: critical revision of article, data collection.

Susanne Erlhöfer, MD: critical revision of article, data collection.

Liz Kuffer, MD: critical revision of article, data collection.

Zeynep Arica: critical revision of article, data collection.

Daniel Steven, MD: concept/design, data analysis/interpretation, data collection.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Arian Sultan
    • 1
  • Barbara Bellmann
    • 1
    Email author
  • Jakob Lüker
    • 1
  • Tobias Plenge
    • 1
  • Jan-Hendrik van den Bruck
    • 1
  • Karlo Filipovic
    • 1
  • Susanne Erlhöfer
    • 1
  • Liz Kuffer
    • 1
  • Zeynep Arica
    • 1
  • Daniel Steven
    • 1
  1. 1.Department of ElectrophysiologyUniversity of CologneKölnGermany

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