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Left atrial voltage mapping with a direction‐independent grid catheter: Comparison with a conventional circular mapping catheter
Author(s) -
Masuda Masaharu,
Asai Mitsutoshi,
Iida Osamu,
Okamoto Shin,
Ishihara Takayuki,
Nanto Kiyonori,
Kanda Takashi,
Tsujimura Takuya,
Matsuda Yasuhiro,
Okuno Shota,
Hata Yosuke,
Mano Toshiaki
Publication year - 2019
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14263
Subject(s) - atrial fibrillation , medicine , catheter , catheter ablation , pulmonary vein , ablation , voltage , cardiology , biomedical engineering , nuclear medicine , surgery , physics , quantum mechanics
A recently introduced grid mapping catheter (GMC) is designed for better electrode‐tissue contact and can collect bipolar signals both along and across the splines, which may allow more efficient voltage map generation independent of propagation direction. We compared the GMC with a conventional circular mapping catheter (CMC) for left atrial (LA) voltage mapping. Methods This study included 20 consecutive patients undergoing repeat ablation for recurrent atrial fibrillation who had demonstrated LA low‐voltage areas (LVAs, <0.10 mV). Following pulmonary vein isolation, LA voltage mapping was performed twice, once using the GMC and once using the CMC. Results Voltage mapping was more efficient using the GMC than the CMC in terms of mapping time (459 [404, 543] vs 602 [496, 814] seconds; P = .014) and the number of mapping points (2446 [2099, 3104] vs 1841 [1494, 2314]; P = .002). The incidence of catheter‐induced ectopies was lower (44 [28, 62] vs 114 [74, 188]; P < .0001) using the GMC. The GMC utilizing all bipoles detected LVAs in 85% of patients with LVAs detected by CMC. LVA measurements were significantly smaller on maps generated by the GMC using bipoles along or across the splines than those measured with the CMC (11.1 [4.6, 17.2] or 9.7 [2.5, 16.0] vs 16.4 [6.8, 26.8] cm 2 ; P = .008 and P = .001, respectively), and were even smaller when using all bipoles (7.9 [1.1, 13.5] cm 2 , P = .0001). Conclusion The GMC allowed a more efficient mapping procedure and enabled more selective identification of LVAs with smaller LVA size.