The combination of electroanatomic mapping and minielectrodes in a series of cases of redo procedures

Figures

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  Fig. 1. Visualization of the 20-pole (orange) and 10-pole (yellow) diagnostic catheters and the MiFi ablation catheter (blue) in Ensite. The green knob on the catheter tip illustrates the minielectrodes.

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  Fig. 2. In this patient with ectopic atrial tachycardia, the tightly coupled minielectrodes ME 2 and ME 3 detected early fractionated signals (*) in the high right atrium that could not be seen in the conventional ablation electrodes MAP 1/2 and MAP 3/4 although all electrodes recorded their signals at the same time. Ablation at this point terminated the tachycardia.

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  Fig. 3. Pulling the ablation catheter out of the right ventricular into the right atrium in order to find the best site to initiate the deployment of a linear lesion in a patient with ongoing flutter. While the conventional ablation electrodes with the wider “antennae” already show signals of atrial flutter (*) suggesting an atrial position of the ablation catheter tip, the minielectrodes still show ventricular signals (°), verifying the placement of the catheter tip in the right ventricle.

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  Fig. 4. This schematic illustrates why the conventional ablation electrodes show signals of atrial flutter whereas the minielectrodes show ventricular signals. VCI: vena cava inferior; RA: right atrium; VCS: vena cava superior; TV: tricuspidal valve; RV: right ventricular; 1, 2, 3, 4: conventional ablation electrodes; CTI: cavotricuspid isthmus.