Key result
PentaRay catheter is linked to ~78% greater mapping of critical Purkinje potentials versus conventional catheters.
Why the study?
Precise mapping of the Purkinje fiber network is essential in catheter ablation of Purkinje-related ventricular arrhythmias, but the mapping ability of multi-spline duodecapolar catheters needed evaluation.
Does mapping with a multi-spline duodecapolar catheter improve the detection of critical Purkinje potentials compared to conventional catheters in patients with Purkinje-related ventricular arrhythmias?
Observational (n=16)
Does mapping with a multi-spline duodecapolar catheter improve the detection of critical Purkinje potentials compared to conventional catheters in patients with Purkinje-related ventricular arrhythmias?
Absolute Event Rate: 100% vs 56.25%
p-value: p=0.004
The PentaRay multi-spline catheter provides superior mapping of critical Purkinje potentials compared to conventional catheters, facilitating targeted ablation of Purkinje-related ventricular arrhythmias.
May facilitate detailed Purkinje mapping in PrVAs; leaves open whether it improves ablation success or outcomes.
BACKGROUND: Precise mapping of the Purkinje fiber network is essential in catheter ablation of Purkinje-related ventricular arrhythmias (PrVAs). We sought to evaluate the mapping ability of a multi-spline duodecapolar catheter (PentaRay) for PrVAs. METHODS: Mappings of Purkinje fibers by PentaRay catheters were compared with those by conventional mapping catheters in consecutive patients undergoing catheter ablation of PrVAs from 2015 to 2022. RESULTS: Sixteen PrVAs (7 premature ventricular contractions or non-reentrant fascicular tachycardias [PVCs/NRFTs] and 9 fascicular ventricular tachycardias [FVTs]) were retrospectively studied. In PVCs/NRFTs, earliest preceding Purkinje potentials (PPs) could be recorded by the PentaRay catheters but not by the mapping and ablation catheters in 5 cases. At the earliest PP sites, the precedence from the QRS onset was greater, and the amplitude of the preceding potentials was higher in the PentaRay catheter compared with those in the mapping and ablation catheter (-62.0 ± 42.8 vs. -29.4 ± 34.2 ms, P = 0.02; 0.45 ± 0.43 vs. 0.09 ± 0.08 mV, P = 0.02). In FVTs, late diastolic potentials (P1) were recorded by the PentaRay catheters but not by the mapping and ablation catheters or the linear duodecapolar catheter in 2 cases. The amplitude of P1 was higher in the PentaRay catheter compared with that in the linear duodecapolar catheter and the mapping and ablation catheters (0.72 ± 0.49 vs. 0.17 ± 0.18 vs. 0.27 ± 0.21 mV, P = 0.0006, P = 0.002). The localized critical PPs, defined as the earliest preceding potentials in PVCs/NRFTs and P1 in FVTs, could be recorded in all the patients by the PentaRay catheter. The mapping ability of critical PPs of PrVAs was better with the PentaRay catheter than with the conventional mapping catheters (16/16 vs. 9/16, P = 0.004 by McNemar exact test). CONCLUSIONS: The PentaRay catheter has clinical advantages in mapping of the Purkinje fiber network to reveal critical PPs as ablation targets of PrVAs.
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Takase et al. (2023) conducted an observational in Purkinje-related ventricular arrhythmias (PrVAs) (n=16). Multi-spline duodecapolar catheter (PentaRay) vs. Conventional mapping catheters was evaluated on Mapping ability of critical Purkinje potentials (PPs) (p=0.004). The PentaRay catheter demonstrated superior mapping ability of critical Purkinje potentials compared to conventional catheters (100% vs 56.25%; P=0.004).
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