Key result
High-density mapping during catheter ablation of complex arrhythmias improves characterization of macro-reentrant circuits and identification of true scar, promising better procedural outcomes.
Why the study?
Does high-density mapping improve the identification of circuits and substrates during catheter ablation of complex arrhythmias?
Does high-density mapping improve the identification of circuits and substrates during catheter ablation of complex arrhythmias?
High-density mapping with multielectrode catheters enhances the identification of arrhythmia circuits and substrates, potentially improving ablation outcomes and reducing procedure times.
Supports high-density mapping for circuit identification in complex arrhythmias; leaves open impact on long-term ablation outcomes.
PURPOSE OF REVIEW: This article uses three commonly encountered clinical scenarios to highlight the value of high-density mapping in the electrophysiology laboratory for the identification of the circuits and substrates during catheter ablation of complex arrhythmias. RECENT FINDINGS: High-density mapping gathered with a multielectrode catheter, with its smaller individual electrode size and closer interelectrode spacing, helps during ablation procedures in a number of ways. When high-density mapping is performed during tachycardia, the characterization of macro-reentrant circuits is better. When there is suspicion of a change in tachycardia during mapping or ablation, the threshold of remapping is significantly lower because of the speed of remapping. When mapping is done during sinus rhythm (substrate mapping), the identification of true scar is more accurate. Lastly, when extensive ablation of a critical isthmus fails to terminate a tachycardia, high-density mapping may reveal the gap(s) along the ablation line and may provide an alternative approach for ablation. SUMMARY: High-density mapping shows promises of improving procedural outcomes with shorter procedural times.
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Shen et al. (2018) conducted a review in complex arrhythmias. High-density mapping was evaluated. High-density mapping during catheter ablation of complex arrhythmias improves characterization of macro-reentrant circuits and identification of true scar, promising better procedural outcomes.
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