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Related Experiment Video

Updated: Oct 10, 2025

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Published on: January 31, 2019

High-resolution parahisian mapping and ablation using microelectrode embedded ablation catheters.

Benjamin Berte¹, Gabi Hilfiker¹, Saagar Mahida²

¹Heart Center, Luzerner Kantonsspital, Lucerne, Switzerland.

|December 13, 2021

Summary

Microelectrode (ME)-embedded catheters precisely map the compact atrioventricular (AV) node, improving ablation safety. This technique accurately defines the AV node region, significantly enhancing ablation efficacy and reducing risks like AV block.

Keywords:

Ablation Atrioventricular nodal region High-density mapping Mapping Microelectrodes

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Last Updated: Oct 10, 2025

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Published on: September 29, 2019

Area of Science:

Electrophysiology
Cardiac Ablation
Medical Device Technology

Background:

Accurate mapping of the compact atrioventricular (AV) node is crucial for successful ablation of various arrhythmias.
Conventional catheter mapping may lack the precision needed for complex AV node targeting.

Purpose of the Study:

To evaluate if microelectrode (ME)-embedded catheters provide more accurate definition of the near-field compact AV node compared to conventional catheters.
To test the hypothesis that ME catheters enhance AV node ablation precision.

Main Methods:

A multicenter prospective study involving 47 patients for mapping and 10 patients for ablation.
Detailed AV junction mapping using ME-embedded catheters, recording His electrograms (EGMs) with conventional (His_c) and microelectrode (His_μ) systems.
AV nodal ablation performed with initial His_c-only or His_μ ablation.

Main Results:

ME-embedded catheters created smaller and more proximally located His_μ clouds compared to His_c (99.4 vs 197.6 mm²; P = .0008).
His_μ EGMs exhibited larger amplitudes than His_c EGMs (0.40 vs 0.16 mV; P = .0002).
His_μ-guided ablation consistently resulted in AV block, unlike His_c-only ablation, demonstrating ME's precision in targeting the critical region.

Conclusions:

Microelectrode technology offers superior accuracy in defining the compact AV node region.
ME-based mapping significantly enhances the safety and efficacy of AV node ablation procedures.
This approach has the potential to reduce complications and improve outcomes in arrhythmia ablation.