Open-Window Mapping for Accessory Pathway Ablation: Influence of Catheter Design on Mapping Performance
Kazuma Iimura1, Atsuhiko Yagishita1, Aika Iijima1
1Department of Cardiology Tokai University School of Medicine Isehara Japan.
Journal of Arrhythmia
|June 22, 2026
Summary
An 8-spline catheter significantly improves mapping efficiency and first-pass success rates during open-window mapping (OWM) for accessory pathway (AP) ablation compared to 5-spline catheters. This suggests catheter design impacts OWM procedural outcomes.
Area of Science:
- Electrophysiology
- Cardiovascular Interventions
Background:
- Open-window mapping (OWM) with the extended early-meets-late (EEML) algorithm is standard for accessory pathway (AP) localization.
- The influence of catheter design on OWM performance and ablation outcomes is not well-established.
Purpose of the Study:
- To evaluate the impact of catheter design on mapping efficiency and procedural success in OWM-guided AP ablation.
Main Methods:
- Retrospective analysis of 43 patients undergoing OWM-guided AP ablation.
- Comparison of mapping characteristics and ablation outcomes between patients mapped with an 8-spline high-density catheter (n=24) and a conventional 5-spline catheter (n=19).
Main Results:
- The 8-spline catheter yielded higher mapping density and shorter mapping times (p<0.001).
- Narrower AP gap width and lower EEML thresholds were observed with the 8-spline catheter (p=0.023 and p=0.003, respectively).
- First-pass AP elimination was 100% with the 8-spline catheter versus 68% with the 5-spline catheter (p=0.004), requiring fewer RF applications (p=0.048).
Conclusions:
- An 8-spline high-density catheter enhances mapping efficiency and first-pass ablation success in OWM procedures.
- Catheter design is a critical factor influencing procedural performance for OWM-guided AP ablation.
