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Related Experiment Video

Updated: Mar 9, 2026

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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Multielectrode vs. point-by-point mapping for ventricular tachycardia substrate ablation: a randomized study.

Juan Acosta1, Diego Penela1, David Andreu1

  • 1Arrhythmia Section, Cardiology Department, Thorax Institute, Hospital Clínic and IDIBAPS (Institut d'Investigació Agustí Pi i Sunyer), Barcelona, Catalonia, Spain.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|January 11, 2017
PubMed
Summary

High-density multielectrode mapping (MEM) improves ventricular tachycardia (VT) substrate ablation by better identifying late potentials and reducing radiofrequency time compared to conventional point-by-point mapping (PPM). This advanced technique enhances ablation guidance for improved patient outcomes.

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Area of Science:

  • Cardiac Electrophysiology
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Ventricular tachycardia (VT) substrate ablation relies on detailed electroanatomical maps (EAM).
  • Conventional point-by-point mapping (PPM) is the standard for creating these maps.
  • High-density multielectrode mapping (MEM) offers a potentially more detailed approach.

Purpose of the Study:

  • To compare the efficacy of high-density multielectrode mapping (MEM) versus conventional point-by-point mapping (PPM) in guiding VT substrate ablation.
  • To evaluate differences in scar visualization, mapping time, and ablation efficiency between MEM and PPM.

Main Methods:

  • A randomized controlled study involving 20 ischemic patients undergoing VT substrate ablation.
  • Patients were randomized to undergo initial mapping with either PPM or MEM (PentaRay catheter).
  • Ablation followed the scar-dechanneling technique, with comparisons of EAM data, procedure time, radiofrequency time, and VT inducibility.

Main Results:

  • MEM identified larger bipolar scar areas compared to PPM (P=0.017).
  • MEM demonstrated a significantly lower far-field/late potential (LP) ratio (P=0.01) and was associated with shorter radiofrequency application time (P=0.023).
  • Mapping and substrate identification times were comparable, and no significant differences in post-ablation VT inducibility were observed between groups.

Conclusions:

  • High-density multielectrode mapping (MEM) with the PentaRay catheter provides superior discrimination of late potentials due to reduced sensitivity to far-field signals.
  • Ablation procedures guided by MEM resulted in shorter radiofrequency application times.
  • MEM represents an advancement in VT substrate ablation, potentially improving procedural efficiency and substrate characterization.