Abstract
Purpose
This study was conducted with the purpose of determining whether or not the potential technical advantages of multi-electrode mapping catheters in catheter ablation (CA) of ventricular tachycardia (VT) result in any relevant clinical benefit for VT patients.
Methods
A single-center VT study, having taken place from 2012 to 2014 using a standard 3.5-mm catheter (Thermocool SF® group 1) and from 2014 to 2016 using a 1-mm multi-electrode-mapping catheter (PentaRay® group 2), was conducted. The endpoint was the complete elimination of late potentials (LPs), local abnormal ventricular activities (LAVA), and VT non-inducibility. Follow-up consisted of device interrogation to monitor for VT recurrence.
Results
Out of 74 VT patients aged 64.5 ± 12.0 years (66 male [89.2%], 56 with ICM [75.7%], and 18 with NICM [24.3%)]), 48 patients (64.9%) were investigated in group 1 and 26 (35.1%) in group 2. Using the multi-point acquisition approach, a tendency to require less mapping time (group 1 65.2 ± 37.6 min, group 2 55.6 ± 34.4 min, p ns) was determined. During 12-month follow-up, 57 patients had freedom from VT recurrences (79.2%). The result was insignificant between the groups (38 patients (79.2%) in group 1 and 19 patients (73.1%) in group 2).
Conclusions
In a single-center observational study, both conventional and high-density mapping approaches in VT patients are comparable in terms of procedure duration and outcome. Mapping time when using a multi-electrode catheter seems to have the tendency of being shorter. We should be encouraged to recruit more patients comparing the benefit of different catheter types.
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Abbreviations
- AT:
-
ablation time
- CA:
-
catheter ablation
- CABG:
-
coronary artery bypass graft
- CRT:
-
cardiac resynchronization therapy
- EAM:
-
electroanatomical mapping
- ECGs:
-
electrocardiograms
- EF:
-
ejection fraction
- FT:
-
fluoroscopy time
- ICD:
-
internal cardioverter defibrillator
- ICM:
-
ischemic cardiomyopathy
- LPs:
-
late potentials
- LAVA:
-
local abnormal ventricular activity
- LV:
-
left ventricle
- MEM:
-
multi-electrode-mapping
- MT:
-
mapping time
- NICM:
-
non-ischemic cardiomyopathy
- NYHA:
-
New York Heart Association
- PBP:
-
point-by-point
- PD:
-
procedure duration
- PVS:
-
programmed ventricular stimulation
- RV:
-
right ventricle
- SHD:
-
structural heart disease
- SR:
-
sinus rhythm
- VT:
-
ventricular tachycardia
- 3D–EAM:
-
three-dimensional electronical mapping
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The study was approved by the Institutional Committee on Human Research. All patients signed consent forms prior to the ablation procedure.
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Maagh, P., Christoph, A., Müller, M.S. et al. Point-by-point versus multisite electrode mapping in VT ablation: does freedom from VT recurrences depend on mapping catheter? An observational study. J Interv Card Electrophysiol 51, 169–181 (2018). https://doi.org/10.1007/s10840-018-0311-9
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DOI: https://doi.org/10.1007/s10840-018-0311-9