Fascicular tachycardia ablation using optrell mapping catheter: a case report.

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Fascicular ventricular tachycardia (VT) is an uncommon idiopathic arrhythmia primarily affecting young individuals without structural heart disease.
• It originates from a reentry mechanism within the Purkinje system, often the posterior fascicle, presenting a specific ECG pattern.
• While generally benign, symptoms can impact quality of life, making catheter ablation a key treatment for refractory cases.

Purpose of the Study:

• To evaluate the safety and efficacy of a novel 48-electrode paddle-shaped catheter for high-density mapping and ablation of fascicular VT.
• To assess the feasibility of using this new technology in a young competitive athlete with recurrent posterior fascicular VT.

Main Methods:

• High-density electroanatomic mapping was performed during tachycardia using a novel 48-electrode paddle-shaped catheter.
• Abnormal Purkinje potentials (P1 and P2) and the critical reentry circuit fusion point were identified at the mid-septum.
• Radiofrequency energy was delivered to the identified critical site for ablation.

Main Results:

• The novel catheter enabled precise identification of abnormal Purkinje potentials and the critical fusion point of the fascicular VT reentry circuit.
• Radiofrequency ablation at the identified site resulted in prompt termination of the arrhythmia.
• The patient remained recurrence-free during a 6-month follow-up period.

Conclusions:

• High-resolution mapping with the novel 48-electrode catheter is safe and effective for ablating fascicular VT.
• This technology facilitates precise targeting of the arrhythmogenic substrate, leading to successful ablation outcomes.
• The use of this novel catheter represents a significant advancement in treating fascicular VT.