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

Area of Science:

• Cardiac Electrophysiology
• Minimally Invasive Cardiovascular Procedures
• Medical Device Technology

Background:

• Limited data exist on the Advisor HD Grid (HDG) catheter and Precision electroanatomic mapping (EAM) system for ventricular arrhythmia (VA) procedures.
• High-density (HD) wave mapping with the HDG catheter and Precision EAM system allows for detailed voltage comparison, independent of wavefront direction or catheter orientation.

Purpose of the Study:

• To summarize the procedural experience using the HDG catheter for ventricular arrhythmia (VA) ablation.
• To evaluate the safety and feasibility of the HDG catheter and Precision EAM system in VA procedures.

Main Methods:

• Retrospective review of 22 patients undergoing VA ablation procedures utilizing the HDG catheter and Precision EAM over a 12-month period.
• Creation of left/right ventricular and aortic electroanatomic maps, with analysis of mapping points, utilization rates, and mapping times.
• Assessment of acute and short-term procedural success and complications.

Main Results:

• Procedures included 18 patients with ventricular tachycardia and 4 with premature ventricular contractions.
• High-density mapping utilized a median of 1700 points for LV substrate maps and 1435 points for RV substrate maps, with 9% total point utilization.
• Mean mapping time was 43 ± 17 minutes, with acute and short-term success rates of 86% and 73%, respectively, and no procedural complications.

Conclusions:

• High-density wave mapping with the HDG catheter and Precision EAM system is safe and feasible for VA procedures in the left ventricle, right ventricle, and aorta.
• Mapping times are comparable to other multielectrode mapping catheters.
• The HDG catheter and Precision EAM system demonstrate efficacy in VA ablation, achieving good success rates with no complications.