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Updated: Dec 30, 2025

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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A novel multielectrode catheter for high-density ventricular mapping: electrogram characterization and utility for

Michael Barkagan1, Jakub Sroubek1, Ayelet Shapira-Daniels1

  • 1Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Harvard-Thorndike Electrophysiology Institute, 185 Pilgrim Road, Baker 4, Boston, MA 02215, USA.

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 28, 2020
PubMed
Summary

A new multielectrode mapping catheter with more, smaller electrodes significantly improves mapping speed and electrogram density in healed infarction ventricles. This enhances the identification of low-amplitude abnormal electrical signals, crucial for scar assessment.

Keywords:
ScarCathetersElectrodesHigh-density mappingMappingSubstrate mappingVentricular tachycardia

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Area of Science:

  • Cardiovascular Electrophysiology
  • Medical Device Technology
  • Cardiac Imaging and Mapping

Background:

  • Multielectrode mapping catheters are valuable for identifying viable myocardial tissue within scar regions.
  • Accurate mapping is essential for understanding ventricular function and guiding therapeutic interventions in patients with myocardial infarction.

Purpose of the Study:

  • To evaluate the effectiveness of a novel multielectrode mapping catheter with an increased number of small, closely spaced electrodes.
  • To compare its performance against a standard catheter for mapping ventricles with healed infarction.

Main Methods:

  • The study involved mapping the left ventricles of 12 swine (4 healthy, 8 with infarction) using an investigational (OctarayTM) and a standard (PentarayTM) catheter.
  • Key parameters assessed included electrogram (EGM) characteristics, mapping efficiency, scar description, and comparison with late gadolinium enhancement (LGE).
  • The investigational catheter features 48 electrodes (vs. 20), smaller surface area (0.9 vs. 2.0 mm²), and fixed 2 mm spacing.

Main Results:

  • The investigational catheter demonstrated a significantly faster electrogram acquisition rate (814 vs. 148 EGM/min) and higher map density (38 vs. 10.1 EGM/cm²).
  • It identified a greater proportion of near-field local abnormal ventricular activities within low-voltage areas (53% vs. 34%), which were classified as far-field EGMs by the standard catheter.
  • Mapping of hemodynamically non-tolerated ventricular tachycardias was more efficient with the investigational catheter due to its higher acquisition rate.

Conclusions:

  • The novel multielectrode mapping catheter enhances mapping speed and electrogram density in ventricles with healed infarction.
  • Its design improves the recognition of low-amplitude, near-field EGMs, offering superior characterization of scar tissue.
  • This technology holds promise for improved diagnostic capabilities in complex cardiac conditions.