Identifying the full diastolic pathway using a grid mapping catheter led to a higher ongoing ventricular tachycardia termination rate during ablation compared to partial recordings (88% vs 45%; P=0.03).
Observational (n=41)
Does the grid mapping catheter (GMC) improve substrate and VT activation mapping during VT ablation procedures in patients undergoing VT ablation?
The grid mapping catheter effectively visualizes full diastolic pathways during VT ablation, which is associated with significantly higher rates of VT termination.
Absolute Event Rate: 88% vs 45%
p-value: p=0.03
BACKGROUND: A new grid mapping catheter (GMC)-allowing for bipolar recordings of the electrograms in each orthogonal direction-became available. The aim of the current study is to evaluate the utility of the GMC in creating substrate and ventricular tachycardia (VT) activation maps during VT ablation procedures. METHODS: From December 2017 to July 2018, 41 consecutive patients undergoing a VT ablation procedure using a GMC were studied. During the substrate mapping, 3 different maps were created using the 3 GMC bipolar configurations (along the spline, across the spline, HD wave solution); the low voltage area and late potential areas were compared. In case of inducible VTs, the GMC was used to create the VT activation maps focusing on the diastolic interval. The relation between diastolic activities during VT and substrate abnormality during sinus rhythm was also investigated. RESULTS: ; P0.05). VT activation mappings using the GMC were performed in 40 VTs, visualizing the full diastolic pathway in 22 (55%) of them. While the latest late potential areas were included in VT diastolic pathway in 17 VTs, the other 6 VTs showed mismatching of them. Identifying the full diastolic pathway led to a higher ongoing VT termination rate during the ablation than in case of partial recordings (88% versus 45%; P=0.03); furthermore, in the former situation, the noninducibility of the targeted VTs was achieved in all cases. CONCLUSIONS: The GMC is a useful tool for performing substrate and VT activation mappings during the VT ablation procedure, precisely identifying the low-voltage areas and quickly visualizing the diastolic pathways.
Okubo et al. (Sun,) conducted a observational in Ventricular Tachycardia (n=41). Grid mapping catheter (GMC) vs. Partial recordings was evaluated on Ongoing VT termination rate during ablation (full vs partial diastolic pathway visualization) (p=0.03). Identifying the full diastolic pathway using a grid mapping catheter led to a higher ongoing ventricular tachycardia termination rate during ablation compared to partial recordings (88% vs 45%; P=0.03).
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