Ultrahigh resolution mapping with the IntellaMap Orion and Rhythmia system produced lower EGM noise than standard catheters (0.011 vs 0.016 mV, P<0.05) and led to AT termination in 97% of cases.
Observational (n=33)
Does mapping with the IntellaMap Orion basket and Rhythmia system accurately identify the critical isthmus and facilitate successful ablation in scar-related atrial tachycardia?
Ultrahigh resolution mapping with the Orion basket and Rhythmia system accurately identifies the critical isthmus in scar-related atrial tachycardias, leading to a 97% acute ablation success rate.
Absolute Event Rate: 0.011% vs 0.016%
p-value: p=<0.05
BACKGROUND: Accurate activation mapping of reentrant scar-related atrial tachycardias (AT) allows efficient radiofrequency ablation by targeting the critical isthmus (CI). We aimed to assess the electrophysiological properties of CI channels during mapping with the IntellaMap Orion basket and the Rhythmia system. METHODS AND RESULTS: We prospectively studied 33 AT (post- atrial fibrillation ablation or surgical mitral valve repair). The noise of bipolar electrogram (EGM) was systematically measured at 10 prespecified sites, as well as on a standard catheter and on the surface ECG. Bipolar EGM of CI regions were analyzed for amplitude, duration, and conduction velocity. The isthmus region to be targeted was chosen based solely on propagation. For each AT, 25 684±14 276 EGMs were automatically annotated. Noise of the Orion EGM was 0.011±0.004 mV, lower than that of a standard catheter (0.016±0.019) and surface ECG (0.02±0.01; P<0.05). For reentrant AT, within the CI, bipolar EGM amplitude (0.08±0.11 mV) and conduction velocity (0.27±0.19 m/s) were lower than those orthodromically before (0.62±0.93 mV; 1±0.49 m/s) and after (0.80±1.59 mV; 1±0.73 m/s) the isthmus (P<0.001 for all). In 97% of AT, ablation at the CI resulted in AT termination. No complications occurred. CONCLUSIONS: This new automated ultrahigh resolution mapping system produces low noise and allows accurate diagnosis of AT circuits. CI on reentrant scar-related AT showed much lower EGM amplitude with a significantly slower conduction velocity than the surrounding parts of the circuit. Ablation of the areas of slow conduction resulted in a high acute success.
Lațcu et al. (Sat,) conducted a observational in Scar-related atrial tachycardia (n=33). IntellaMap Orion basket and Rhythmia system vs. Standard catheter was evaluated on Noise of bipolar electrogram (mV) (p=<0.05). Ultrahigh resolution mapping with the IntellaMap Orion and Rhythmia system produced lower EGM noise than standard catheters (0.011 vs 0.016 mV, P<0.05) and led to AT termination in 97% of cases.