The utility of manually controlled steerable sheath in epicardial mapping and ablation procedure in patients with
Hiroya Mizuno1, Giuseppe Maccabelli, Paolo Della Bella
1Department of Advanced Cardiovascular Therapeutics, Osaka University, Osaka, Japan.
Insights
A manually controlled steerable sheath improved success rates for mapping and ablating epicardial ventricular tachycardia (VT). This flexible tool enhanced procedural outcomes and patient safety in VT ablation procedures.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Epicardial ventricular tachycardia (VT) poses challenges in diagnosis and treatment.
- Conventional mapping and ablation techniques may have limitations in achieving complete epicardial coverage.
Purpose of the Study:
- To evaluate the efficacy and safety of a manually controlled steerable sheath in epicardial VT mapping and ablation.
- To compare procedural success rates between steerable and conventional sheaths for VT ablation.
Main Methods:
- Retrospective review of 40 patients undergoing epicardial mapping and ablation for VT.
- Utilized a manually controlled steerable sheath in a subset of patients after initial attempts with conventional methods.
- Assessed procedural success based on detailed epicardial mapping and VT abolishment post-ablation.
Main Results:
- Initial mapping success was achieved in 16 patients using conventional methods.
- The steerable sheath enabled complete epicardial mapping in all remaining 24 patients.
- Procedural success rates were higher with the steerable sheath (21/24) compared to the conventional sheath (10/16).
- No procedure-related adverse events were reported.
Conclusions:
- The manually controlled steerable sheath is a safe and effective tool for epicardial VT ablation.
- This device improves the ability to achieve detailed epicardial mapping and successful VT elimination.
Aims:
The aim of this study is to evaluate the benefit of manually controlled steerable sheath, which provides greater flexibility and stability, in mapping and ablation procedure of ventricular tachycardia.
Methods And Results:
We retrospectively reviewed 40 patients who underwent epicardial mapping and conclusive ablation. The first attempt to reach the primary endpoint defined as successful creation of detailed map of entire epicardial space and was achieved in 16 patients. Among the remaining 24 patients, we used the steerable sheath and achieved further success to create an entire map in all patients. After the delivery of RF energy, final procedural success was defined as complete abolishment of late potential and no more induction of any VT, and that was obtained in 10 out of 16 patients mapped with conventional sheath and 21 out of 24 patients with steerable sheath. The advantage of the steerable sheath seemed to be consistent, regardless of the site of ablation. There was no procedure-related adverse event.
Conclusions:
The manually controlled steerable sheath was safe and effective to achieve procedural success in patients with epicardial VT.
