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High-density electroanatomic mapping with grid catheter in pediatrics and congenital heart disease

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Abstract

Background

The Advisor™ HD Grid mapping catheter (Abbott Laboratories; Chicago, IL) allows for bipolar electrogram collection in both orthogonal and perpendicular planes, unique when compared to traditional and branch catheters. Experience in pediatric patients and congenital heart disease (CHD) is limited. The purpose of this work was to evaluate the utility and safety of the Advisor™ HD Grid mapping catheter in pediatric and CHD populations.

Methods

Retrospective review of all pediatric patients and those with CHD (regardless of age) at Children’s Hospital Colorado and University of Colorado undergoing electrophysiologic study in which the Advisor™ HD Grid mapping catheter was utilized.

Results

Sixty-five procedures in 60 patients (N = 31 female (47.6%), median age 17 years (15–24.1)) were included. Patients had CHD in 30 procedures (46.1%). Eight-eight arrhythmia substrates were mapped including atrial flutter/intra-atrial reentrant tachycardia (N = 33), focal atrial tachycardia (N = 20), isolated PVCs (N = 10), accessory pathways (N = 9), atrioventricular nodal reentrant tachycardia (N = 7), right ventricular substrate mapping (N = 7), and ventricular tachycardia (N = 2). Median time per map was 11.8 (7.5–20.1) min with 3.2 (± 1.7) maps per procedure and a median of 2634 (1767–7654) points used per map. Patients with CHD required more maps (p < 0.001) and points per map (p < 0.001). Ablation was successful in 92.4% of procedures.

Conclusions

The Advisor™ HD Grid mapping catheter is safe and effective in the pediatric and congenital heart disease population. A wide variety of arrhythmia substrates can be mapped with high point density and low mapping time.

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Abbreviations

HD:

High density

CHD:

Congenital heart disease

AFL:

Atrial flutter

IART:

Intra-atrial reentrant tachycardia

FAT:

Focal atrial tachycardia

AP:

Accessory pathway

AVNRT:

Atrioventricular nodal reentrant tachycardia

PVC:

Premature ventricular contraction

VT:

Ventricular tachycardia

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Acknowledgements

The authors would like to acknowledge the technical advisement provided by Austin Davies regarding the Advisor™ HD Grid catheter and the EnSite™ mapping system.

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Authors and Affiliations

  1. Children’s Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Ave, B100, Aurora, CO, 80045, USA

    Johannes C. von Alvensleben, D. Martin Runciman, Melissa Wehrmann, Michal Schäfer & Kathryn K. Collins

  2. University of Colorado Hospital, University of Colorado School of Medicine, Aurora, CO, USA

    Johannes C. von Alvensleben, Amneet Sandhu, Shu Chang & D. Wendy Tzou

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  1. Johannes C. von Alvensleben
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  2. Amneet Sandhu
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  3. Shu Chang
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Correspondence to Johannes C. von Alvensleben.

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Approval for the study was obtained from the Institutional Review Board from the University of Colorado and Children’s Hospital Colorado.

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von Alvensleben, J.C., Sandhu, A., Chang, S. et al. High-density electroanatomic mapping with grid catheter in pediatrics and congenital heart disease. J Interv Card Electrophysiol 66, 611–619 (2023). https://doi.org/10.1007/s10840-022-01364-0

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