Mapping with a 64-pole basket catheter commonly results in interspline distances >20 mm, leading to <50% coverage of the left atrial surface, with a maximum of 65% coverage in ideal simulations.
Does the use of a 64-pole basket catheter provide adequate endocardial coverage during atrial mapping?
Basket catheters frequently experience spline bunching leading to less than 50% left atrial coverage, which must be considered when interpreting excitation patterns.
Whole-chamber mapping using a 64-pole basket catheter (BC) has become a featured approach for the analysis of excitation patterns during atrial fibrillation. A flexible catheter design avoids perforation but may lead to spline bunching and influence coverage. We aim to quantify the catheter deformation and endocardial coverage in clinical situations and study the effect of catheter size and electrode arrangement using an in silico basket model. Atrial coverage and spline separation were evaluated quantitatively in an ensemble of clinical measurements. A computational model of the BC was implemented including an algorithm to adapt its shape to the atrial anatomy. Two clinically relevant mapping positions in each atrium were assessed in both clinical and simulated data. The simulation environment allowed varying both BC size and electrode arrangement. Results showed that interspline distances of more than 20 mm are common, leading to a coverage of less than 50% of the left atrial (LA) surface. In an ideal in silico scenario with variable catheter designs, a maximum coverage of 65% could be reached. As spline bunching and insufficient coverage can hardly be avoided, this has to be taken into account for interpretation of excitation patterns and development of new panoramic mapping techniques.
Oesterlein et al. (Fri,) conducted a other in Atrial fibrillation. 64-pole basket catheter was evaluated on Catheter deformation and endocardial coverage. Mapping with a 64-pole basket catheter commonly results in interspline distances >20 mm, leading to <50% coverage of the left atrial surface, with a maximum of 65% coverage in ideal simulations.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: