Substrate and arrhythmia characterization using the multi-electrode Optrell mapping catheter for ventricular
Jian Liang Tan1, Gustavo S Guandalini1, Matthew C Hyman1
1Electrophysiology Section, Cardiology Division, Hospital of the University of Pennsylvania, 1 Convention Avenue, Philadelphia, PA, 19104, USA.
Summary
The Optrell multipolar mapping catheter (MPMC) offers a safe and effective method for high-density mapping during ventricular tachycardia and premature ventricular complex ablation. While manipulation can be challenging in certain areas, it enables detailed cardiac mapping.
Area of Science:
- Electrophysiology
- Cardiovascular Medicine
- Medical Devices
Background:
- The application of multi-electrode mapping catheters in ventricular tachycardia (VT) and premature ventricular complex (PVC) ablation is not extensively documented.
- The Optrell multipolar mapping catheter (MPMC) represents a novel tool for cardiac electrophysiological mapping.
Purpose of the Study:
- To evaluate the feasibility and safety of employing the Optrell multipolar mapping catheter (MPMC) for guiding catheter ablation procedures in patients with VT and PVCs.
- To assess the capability of the MPMC in generating high-density electroanatomical maps for complex arrhythmia ablation.
Main Methods:
- A retrospective analysis of 20 patients undergoing VT or PVC ablation between June and November 2022 at a single center.
- Utilized the Optrell multipolar mapping catheter (MPMC) for high-density voltage and activation mapping in both endocardial and epicardial regions.
- Documented procedural details, mapping points collected, and any identified challenges or limitations during catheter manipulation.
Main Results:
- High-density mapping was successfully performed, collecting a median of 2753 points endocardially and 12,830 points epicardially in VT cases.
- Late potentials were detected in 11 patients, with 7 showing isochronal crowding, and critical circuitry was confirmed in two cases.
- Operators experienced challenges manipulating the MPMC in trabeculated areas and near the valve apparatus, with a noted longer wait time for matrix formation.
Conclusions:
- The Optrell multipolar mapping catheter (MPMC) is a safe and effective tool for creating high-density electroanatomical maps in the left ventricular endocardium and epicardium.
- The MPMC facilitates detailed mapping crucial for complex VT and PVC ablation strategies.
- Catheter manipulation in specific cardiac regions and initial matrix formation time are limitations to consider when using the MPMC.
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