Key result
CARTOFINDER mapping using the OctaRay catheter identified more focal and rotational activation sites than the PentaRay catheter, though focal reproducibility was lower (45.3% vs 58.9%, p<0.001).
Why the study?
The study aimed to elucidate reliable atrial fibrillation drivers identified by CARTOFINDER using the OctaRay catheter.
Does CARTOFINDER mapping using the OctaRay catheter improve the identification of reliable focal and rotational activations compared to the PentaRay catheter in patients with persistent atrial fibrillation?
Observational (n=28)
Does CARTOFINDER mapping using the OctaRay catheter improve the identification of reliable focal and rotational activations compared to the PentaRay catheter in patients with persistent atrial fibrillation?
The OctaRay catheter, when used with CARTOFINDER, identifies reliable focal and rotational activations with higher resolution than the PentaRay catheter in patients with persistent atrial fibrillation.
Sequential CARTOFINDER mapping shows variable reproducibility in persistent AF; hypothesis-generating and requires validation before clinical use.
INTRODUCTION: The aim of the current study was to elucidated the reliable atrial fibrillation (AF) drivers identified by CARTOFINDER using OctaRay catheter. METHODS AND RESULTS: The reliability of focal and rotational activations identified by CARTOFINDER using OctaRay catheter was assessed by the sequential recordings in each site of both atrium before and after pulmonary vein isolation (PVI) in 10 persistent AF patients. The outcome measures were the reproducibility rate during the sequential recordings and the stability rate between pre- and post-PVI as reliable focal and rotational activations. The study results were compared with those under use of PentaRay catheter (N = 18). Total 68928 points of 360 sites in OctaRay group and 24 177 points of 311 sites in PentaRay were assessed. More focal activation sites were identified in OctaRay group than PentaRay group (7.9% vs. 5.7%, p < .001), although the reproducibility rate and the stability rate were significantly lower in OctaRay group (45.3% vs. 58.9%, p < .001; 11.2% vs. 28.4%, p < .001). Meanwhile, the prevalence of reproducible focal activation sites among overall points was comparable (3.6% vs. 3.3%, p = .08). Regarding rotational activation, more rotational activation sites were identified in OctaRay group (5.1% vs. 0.2%, p < .001), and the reproducibility rate and the stability rate were significantly higher in OctaRay group (45.2% and 12.5% vs. 0.0%, p < .001). Both reliable focal and rotational activation sites were characterized by significantly shorter AF-cycle length (CL) and higher repetition of focal and rotational activations during the recordings compared with the sites of non or unreliable focal and rotational activations. CONCLUSION: In CARTOFINDER, OctaRay catheter could identify reliable focal activation with high resolution and reliable rotational activation compared with PentaRay catheter. The repetitive focal and rotational activations with short AF-CL could be the potential target during ablation.
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Kawaji et al. (2023) conducted an observational in Persistent atrial fibrillation (n=28). CARTOFINDER mapping using OctaRay catheter vs. PentaRay catheter was evaluated on Reproducibility rate of focal activations during sequential recordings (p=<.001). CARTOFINDER mapping using the OctaRay catheter identified more focal and rotational activation sites than the PentaRay catheter, though focal reproducibility was lower (45.3% vs 58.9%, p<0.001).
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