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Substrate and arrhythmia characterization using the multi-electrode Optrell mapping catheter for ventricular arrhythmia ablation—a single-center experience

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Abstract

Background

The use of a multi-electrode Optrell mapping catheter during ventricular tachycardia (VT) or premature ventricular complex (PVC) ablation procedures has not been widely reported.

Objectives

We aim to describe the feasibility and safety of using the Optrell multipolar mapping catheter (MPMC) to guide catheter ablation of VT and PVCs.

Methods

We conducted a single-center, retrospective evaluation of patients who underwent VT or PVC ablation between June and November 2022 utilizing the MPMC.

Results

A total of 20 patients met the inclusion criteria (13 VT and 7 PVC ablations, 80% male, 61 ± 15 years). High-density mapping was performed in the VT procedures with median 2753 points [IQR 1471–17,024] collected in the endocardium and 12,830 points [IQR 2319–30,010] in the epicardium. Operators noted challenges in manipulation of the MPMC in trabeculated endocardial regions or near valve apparatus. Late potentials (LPs) were detected in 11 cases, 7 of which had evidence of isochronal crowding demonstrated during late annotation mapping. Two patients who also underwent entrainment mapping had critical circuitry confirmed in regions of isochronal crowding. In the PVC group, high-density voltage and activation mapping was performed with a median 1058 points [IQR 534–3582] collected in the endocardium.

Conclusions

This novel MPMC can be used safely and effectively to create high-density maps in LV endocardium or epicardium. Limitations of the catheter include a longer wait time for matrix formation prior to starting point collection and challenges in manipulation in certain regions.

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Abbreviations

AAD:

Antiarrhythmic drug

ECG:

Electrocardiography

ICD:

Implantable cardioverter-defibrillator

ILAM:

Isochronal late annotation mapping

LPs:

Late potentials

PVC:

Premature ventricular complex

VA:

Ventricular arrhythmia

VT:

Ventricular tachycardia

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Funding

This work was supported by the Pennsylvania Steel Company EP Research Fund and the Winkelman Family Fund in Cardiovascular Innovation.

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Authors and Affiliations

  1. Electrophysiology Section, Cardiology Division, Hospital of the University of Pennsylvania, 1 Convention Avenue, Philadelphia, PA, 19104, USA

    Jian Liang Tan, Gustavo S. Guandalini, Matthew C. Hyman, Robert D. Schaller, Fermin Garcia, Gregory Supple, David S. Frankel, Saman Nazarian, David Lin, David Callans, Francis E. Marchlinski & Timothy M. Markman

  2. Electrophysiology Section, Lancaster Heart Group, Lancaster General Hospital, Lancaster, PA, USA

    Jeffrey Arkles

  3. Cardiac Pacing and Electrophysiology Section, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH, USA

    Pasquale Santangeli

Authors
  1. Jian Liang Tan
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  2. Gustavo S. Guandalini
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  3. Matthew C. Hyman
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  4. Jeffrey Arkles
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  5. Pasquale Santangeli
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  6. Robert D. Schaller
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  7. Fermin Garcia
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  8. Gregory Supple
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  9. David S. Frankel
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  10. Saman Nazarian
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  11. David Lin
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  12. David Callans
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  13. Francis E. Marchlinski
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  14. Timothy M. Markman
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Corresponding author

Correspondence to Timothy M. Markman.

Ethics declarations

Ethical approval

Retrospective use of data was approved by the IRB of the University of Pennsylvania.

Conflict of interest

DSF: lecture honoraria from and investigator for Biosense Webster. SN: consultant for CardioSolv, ImriCor, Dyne Pharmaceuticals, and Circle CVI; and principal investigator for research funding from Biosense Webster, ImriCor, and ADAS software. FM: consultant for Biosense Webster, Abbot Medical, and Medtronic; and has served as an investigator with research funding from Biosense Webster. TM: consultant for Biosense Webster. The remainder of the authors report nothing relevant to disclose.

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Tan, J.L., Guandalini, G.S., Hyman, M.C. et al. Substrate and arrhythmia characterization using the multi-electrode Optrell mapping catheter for ventricular arrhythmia ablation—a single-center experience. J Interv Card Electrophysiol 67, 559–569 (2024). https://doi.org/10.1007/s10840-023-01618-5

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  • DOI: https://doi.org/10.1007/s10840-023-01618-5

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