Ultra-high resolution mapping and ablation of accessory pathway conduction
Shinsuke Miyazaki1, Eri Ishikawa2, Moe Mukai2
1Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimo-aiduki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan. mshinsuke@k3.dion.ne.jp.
Summary
Ultra-high resolution mapping and a novel algorithm effectively located accessory pathways (APs) for ablation. This advanced technique demonstrated successful AP elimination with no recurrences during follow-up.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Technology
Background:
- Accessory pathway (AP) mapping lacked detailed studies with ultra-high resolution systems.
- Previous methods did not fully utilize advanced mapping capabilities for AP ablation.
Purpose of the Study:
- To evaluate the clinical utility of ultra-high resolution mapping systems for accessory pathway ablation.
- To assess the effectiveness of the novel "Lumipoint" algorithm in localizing accessory pathways.
Main Methods:
- Seventeen patients underwent accessory pathway mapping using minielectrode basket catheters and Rhythmia systems.
- Ablation was performed using 4-mm irrigated-tip catheters.
- Activation maps were generated during various pacing conditions.
Main Results:
- Ultra-high resolution mapping successfully identified accessory pathways in most patients.
- The Lumipoint algorithm highlighted earliest activation areas and complex activation patterns.
- All accessory pathways were successfully eliminated with short ablation application times.
- No recurrences were observed during a median follow-up of 15 months.
- Local electrogram characteristics differed between minielectrode and ablation catheters at successful sites.
Conclusions:
- Ultra-high resolution activation mapping, aided by the Lumipoint algorithm, facilitates accessory pathway localization.
- Distinct electrogram characteristics were observed between minielectrode and ablation catheters.
