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Related Experiment Video

Updated: Dec 9, 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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Prospective STAR-Guided Ablation in Persistent Atrial Fibrillation Using Sequential Mapping With Multipolar

Shohreh Honarbakhsh1, Richard J Schilling1, Malcolm Finlay1

  • 1Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom.

Circulation. Arrhythmia and Electrophysiology
|September 9, 2020
PubMed
Summary

Stochastic trajectory analysis of ranked signals (STAR) mapping effectively guided ablation for atrial fibrillation (AF) using conventional catheters. This approach led to high rates of AF termination and long-term freedom from the arrhythmia.

Keywords:
atrial fibrillationcatheter ablationcoronary sinuspulmonary veintachycardia

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Atrial fibrillation (AF) ablation guided by novel Stochastic Trajectory Analysis of Ranked Signals (STAR) mapping has shown promise.
  • Previous studies utilized basket catheters for STAR mapping.

Purpose of the Study:

  • To evaluate the efficacy of STAR mapping using sequential recordings from conventional pulmonary vein mapping catheters for AF ablation.
  • To determine if this approach could achieve results similar to basket catheter STAR mapping.

Main Methods:

  • Persistent AF patients (<2 years) underwent pulmonary vein isolation.
  • Sequential STAR mapping with multipolar catheters (PentaRay, IntellaMap Orion, Advisor HD Grid) identified AF drivers (AFDs).
  • AFDs were targeted for ablation, with an ablation response defined as AF termination or cycle length slowing ≥30 ms.

Main Results:

  • 27 patients underwent STAR-guided ablation, identifying 3.1±1.1 AFDs per patient.
  • 77.1% of targeted AFDs (54/70) showed an ablation response, including AF termination or cycle length slowing.
  • 81.5% of patients (22/27) remained free from AF/atrial tachycardia off antiarrhythmic drugs at 17.3 months follow-up.

Conclusions:

  • STAR-guided ablation using sequential mapping with multipolar catheters is effective for AF.
  • The method achieved ablation response in all patients and high long-term freedom from AF/atrial tachycardia.
  • This technique offers a viable alternative to basket catheter-based STAR mapping for AF ablation.