Catheter ablation of ventricular arrhythmia guided by a high-density grid catheter

Timothy Campbell; Ivana Trivic; Richard G Bennett; Robert D Anderson; Samual Turnbull; Timmy Pham; Chrishan Nalliah; Eddy Kizana; Troy Watts; Geoffrey Lee; Saurabh Kumar

doi:10.1111/jce.14351

Catheter ablation of ventricular arrhythmia guided by a high-density grid catheter

J Cardiovasc Electrophysiol. 2020 Feb;31(2):474-484. doi: 10.1111/jce.14351. Epub 2020 Jan 20.

Authors

Timothy Campbell^{1

2}, Ivana Trivic^{1

2

3

4}, Richard G Bennett^{1

2}, Robert D Anderson², Samual Turnbull^{1

2}, Timmy Pham^{1

2}, Chrishan Nalliah^{1

2}, Eddy Kizana^{1

2}, Troy Watts^{3

4}, Geoffrey Lee^{3

4}, Saurabh Kumar^{1

2}

Affiliations

¹ Department of Cardiology, Westmead Hospital, Sydney, Australia.
² Westmead Applied Research Centre, University of Sydney, Sydney, New South Wales, Australia.
³ Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia.
⁴ Faculty of Medicine, Dentistry, and Health Science, University of Melbourne, Melbourne, Victoria, Australia.

PMID: 31930658
DOI: 10.1111/jce.14351

Abstract

Introduction: Minimal data exist on the Advisor HD Grid (HDG) catheter and the Precision electroanatomic mapping (EAM) system for ventricular arrhythmia (VA) procedures. Using the HDG catheter, the EAM uses the high-density (HD) wave mapping and best duplicate software to compare the maximum peak-to-peak bipolar voltages within a small zone independent of wavefront direction and catheter orientation. This study aimed to summarize the procedural experience for VAs using the HDG catheter.

Methods: Clinical and procedural characteristics of VA ablation procedures were retrospectively reviewed that used the HDG catheter and the Precision EAM over a 12-month period.

Results: A total of 22 patients, 18 with sustained ventricular tachycardia and 4 with premature ventricular contractions were included. Clinically indicated left and/or right ventricular (LV, RV, respectively), and aortic maps were created. LV substrate maps (n = 13) used a median 1700 points (interquartile range [IQR]_25%-75% , 1427-2412) out of a median 18 573 (IQR_25%-75% , 15 713-41 067) total points collected. RV substrate maps (n = 11) used a median 1435 points (IQR_25%-75% , 1114-1871) out of a median 16 005 (IQR_25%-75% , 11 063-21 405) total points collected. Total point utilization, used vs collected, was 9%. Mean mapping time was 43 ± 17 minutes (substrate, 34 ± 18 minutes; activation/pace mapping, 9 ± 13 minutes). Acute success was achieved in 56 (86%) and short-term success achieved in 16 patients (73%) at a median follow-up of 145 days (IQR_25%-75% , 62-273 days). There were no procedural complications.

Conclusion: HD wave mapping using the novel HDG catheter integrated with the Precision EAM is safe and feasible in VA procedures in the LV, RV, and aorta. Mapping times are consistent with other multielectrode mapping catheters.

Keywords: catheter ablation; electroanatomic mapping; electrophysiology; multielectrode mapping; ventricular arrhythmias.

Publication types

Research Support, Non-U.S. Gov't
Video-Audio Media

MeSH terms

Action Potentials*
Adult
Aged
Cardiac Catheterization / adverse effects
Cardiac Catheterization / instrumentation*
Cardiac Catheters*
Catheter Ablation / adverse effects
Catheter Ablation / instrumentation*
Electrophysiologic Techniques, Cardiac / instrumentation*
Female
Heart Rate*
Humans
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Signal Processing, Computer-Assisted
Software
Tachycardia, Ventricular / diagnosis
Tachycardia, Ventricular / physiopathology
Tachycardia, Ventricular / surgery*
Time Factors
Treatment Outcome
Ventricular Premature Complexes / diagnosis
Ventricular Premature Complexes / physiopathology
Ventricular Premature Complexes / surgery*