What question did this study set out to answer?

To evaluate the procedural efficiency and accuracy of low-voltage area identification using a direction-independent grid mapping catheter compared to a conventional circular mapping catheter.

November 8, 2019Journal of Cardiovascular Electrophysiology

Left atrial voltage mapping with a direction‐independent grid catheter: Comparison with a conventional circular mapping catheter

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Why the study?

A novel grid mapping catheter collecting bipolar signals along and across splines may improve LA voltage mapping efficiency independent of propagation direction compared to conventional circular mapping catheters.

Does a grid mapping catheter improve mapping efficiency and LVA identification compared to a conventional circular mapping catheter in patients undergoing repeat ablation for recurrent atrial fibrillation?

Population

20 consecutive patients undergoing repeat ablation for recurrent AF with demonstrated LA low-voltage areas

Comparison

Grid mapping catheter vs conventional circular mapping catheter for LA voltage mapping

Design

Consecutive comparative study

Authors

MMMasaharu MasudaElectrophysiology MAMitsutoshi AsaiElectrophysiology OIOsamu IidaInterventional Cardiology

Discussion

Member takes

Implication

GMC may enable faster mapping with refined LVA detection in repeat AF; leaves open impact on outcomes versus CMC.

Key Points

To evaluate the procedural efficiency and accuracy of low-voltage area identification using a direction-independent grid mapping catheter compared to a conventional circular mapping catheter.
Prospective within-patient comparative study of N=20 consecutive patients undergoing repeat catheter ablation for recurrent atrial fibrillation with pre-existing left atrial low-voltage areas (<0.10 mV).
Sequential left atrial voltage mapping was performed following pulmonary vein isolation using both the grid mapping catheter and the circular mapping catheter.
The grid mapping catheter achieved shorter mapping times (459 [404, 543] vs 602 [496, 814] seconds; P=0.014), recorded more mapping points (2446 [2099, 3104] vs 1841 [1494, 2314]; P=0.002), and caused fewer catheter-induced ectopies (44 [28, 62] vs 114 [74, 188]; P<0.0001) than the circular catheter.
Low-voltage area measurements were significantly smaller with the grid catheter using all bipoles compared to the circular mapping catheter (7.9 [1.1, 13.5] vs 16.4 [6.8, 26.8] cm²; P=0.0001).

Structured PICO

Population

20 consecutive patients undergoing repeat ablation for recurrent atrial fibrillation who had demonstrated LA low-voltage areas (LVAs, <0.10 mV)

Intervention

Left atrial voltage mapping using a grid mapping catheter (GMC)

Comparator

Left atrial voltage mapping using a conventional circular mapping catheter (CMC)

Outcome

Mapping efficiency (mapping time and number of mapping points) and LVA sizesurrogate

The grid mapping catheter provides more efficient left atrial voltage mapping with fewer catheter-induced ectopies and more selective identification of low-voltage areas compared to a conventional circular mapping catheter.

Cite This Study

Masuda et al. (2019) studied this question.

synapsesocial.com/papers/6a0a594e97b2cd65685918ea https://doi.org/10.1111/jce.14263

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes

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Left atrial voltage mapping with a direction‐independent grid catheter: Comparison with a conventional circular mapping catheter

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Left atrial voltage mapping with a direction‐independent grid catheter: Comparison with a conventional circular mapping catheter

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider