Recording monophasic action potentials using a platinum-electrode ablation catheter.

Area of Science:

• Cardiovascular Electrophysiology
• Medical Device Technology

Background:

• Monophasic action potentials (MAPs) are crucial for identifying local activation during cardiac procedures.
• Conventional Ag-AgCl electrodes used for MAP recording are unsuitable for radiofrequency current delivery.
• A MAP-guided catheter ablation technique requires electrodes capable of both recording and delivering energy.

Purpose of the Study:

• To explore the feasibility of recording MAPs using platinum electrodes integrated into standard ablation catheters.
• To assess the potential for developing a MAP-guided catheter ablation technique.

Main Methods:

• MAP recordings were obtained from the endocardium of 40 patients using an ablation catheter.
• Simultaneous recordings of MAPs and electrograms were performed in eight patients during mapping and ablation.
• MAP recordings from the ablation catheter were compared with those from a conventional Ag-AgCl electrode catheter.

Main Results:

• Stable MAP baselines were achieved in 90% of ventricular and 100% of atrial recordings.
• MAPs recorded via the ablation catheter provided clearer local activation signals compared to standard electrograms.
• Recordings using the ablation catheter's platinum electrodes were consistent with those from Ag-AgCl electrodes.

Conclusions:

• Platinum electrodes are suitable for accurate MAP recording in clinical settings.
• Simultaneous MAP recording and radiofrequency delivery via the same platinum-tip electrode are feasible.
• These findings support the technical possibility of implementing MAP-guided catheter ablation.