Mapping with 1-mm multielectrode catheters identified a 22.5% smaller area of low bipolar voltage amplitude compared to 3.5-mm catheters (21.7 vs 28.0 cm2; P=0.003).
Does mapping with 1-mm multielectrode catheters improve mapping resolution within ventricular scar compared to 3.5-mm catheters in a swine model of healed myocardial infarction?
High-resolution mapping with 1-mm multielectrode catheters improves the identification of preserved myocardial tissue channels within ventricular scars compared to standard 3.5-mm catheters.
Absolute Event Rate: 21.7% vs 28%
p-value: p=0.003
BACKGROUND: Mapping resolution is influenced by electrode size and interelectrode spacing. The aims of this study were to establish normal electrogram criteria for 1-mm multielectrode-mapping catheters (Pentaray) in the ventricle and to compare its mapping resolution within scar to standard 3.5-mm catheters (Smart-Touch Thermocool). METHODS AND RESULTS: Three healthy swine and 11 swine with healed myocardial infarction underwent sequential mapping of the left ventricle with both catheters. Bipolar voltage amplitude in healthy tissue was similar between 3.5- and 1-mm multielectrode catheters with a 5th percentile of 1.61 and 1.48 mV, respectively. In swine with healed infarction, the total area of low bipolar voltage amplitude (defined as <1.5 mV) was 22.5% smaller using 1-mm multielectrode catheters (21.7 versus 28.0 cm2; P=0.003). This was more evident in the area of dense scar (bipolar amplitude <0.5 mV) with a 47% smaller very low-voltage area identified using 1-mm electrode catheters (7.1 versus 15.2 cm(2); P=0.003). In this region, 1-mm multielectrode catheters recorded higher voltage amplitude (0.72±0.81 mV versus 0.30±0.12 mV; P<0.001). Importantly, 27% of these dense scar electrograms showed distinct triphasic electrograms when mapped using a 1-mm multielectrode catheter compared with fractionated multicomponent electrogram recorded with the 3.5-mm electrode catheter. In 8 mapped reentrant ventricular tachycardias, the circuits included regions of preserved myocardial tissue channels identified with 1-mm multielectrode catheters but not 3.5-mm electrode catheters. Pacing threshold within the area of low voltage was lower with 1-mm electrode catheters (0.9±1.3 mV versus 3.8±3.7 mV; P=0.001). CONCLUSIONS: Mapping with small closely spaced electrode catheters can improve mapping resolution within areas of low voltage.
Tschabrunn et al. (Wed,) conducted a other in Healed myocardial infarction (n=14). 1-mm multielectrode-mapping catheters vs. 3.5-mm catheters was evaluated on Total area of low bipolar voltage amplitude (<1.5 mV) (p=0.003). Mapping with 1-mm multielectrode catheters identified a 22.5% smaller area of low bipolar voltage amplitude compared to 3.5-mm catheters (21.7 vs 28.0 cm2; P=0.003).
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