Key result
Mini-electrode mapping of RVOT VAs detects shorter spiky and increased reverse late potentials versus conventional catheters.
Why the study?
The architecture of the roving catheter may compromise target electrogram quality in RVOT VAs, and mini-electrodes could improve mapping resolution in low-voltage areas.
Does mapping with mini-electrodes improve the resolution of the earliest activation site compared to conventional ablation catheters in patients with RVOT ventricular arrhythmias?
Observational (n=27)
Does mapping with mini-electrodes improve the resolution of the earliest activation site compared to conventional ablation catheters in patients with RVOT ventricular arrhythmias?
Mini-electrode mapping improves the resolution of the earliest activation site in RVOT ventricular arrhythmias compared to conventional ablation catheters.
Answers are grounded in this paper and cite their sources.
May enhance mapping resolution in RVOT VAs; hypothesis-generating and requires prospective validation before practice change.
INTRODUCTION: Right ventricular outflow tract ventricular arrhythmias (RVOT VAs) often originate in the voltage-transitional zone. The target electrogram could be compromised by the architecture of the roving catheter. Mini-electrodes could improve the mapping resolution, especially in low-voltage areas. The aim was to assess the electrophysiological characteristics of the earliest activation site (EAS) of RVOT VAs during mapping using mini-electrodes. METHODS AND RESULTS: Twenty-seven patients with RVOT-type VAs were mapped using Orion mini-electrodes and the Rhythmia mapping system. Bipolar and unipolar electrograms were analyzed and compared with conventional ablation catheter recordings. Twenty-five patients (25 of 27) were successfully mapped and ablated at the RVOT. At the EAS, all 25 (100%) patients exhibited local sharp potentials (spiky potential) at the VAs, and 88% (22 of 25) individuals showed reverse late potentials in adjacent sinus beats on the bipolar mini-electrode recordings. Related unipolar electrograms manifested 20% "q-plateau-QS," 76% "gross QS," and 4% "late QS" patterns related to spiky potential voltages and advanced times. Compared with electrograms recorded by ablation catheter, bipolar mini-electrode recordings exhibited significantly shorter spiky potential durations (P = 0.001) and a significantly increased incidence of the reverse late potentials (P = 0.041). Unipolar mini-electrode recordings had a lower incidence ratio of "late QS" patterns (P = 0.039). CONCLUSION: Compared with ablation catheter mapping, mini-electrodes improved the mapping resolution of the EAS of RVOT VAs and exhibited shorter spiky potential durations and reduced incidence of "later QS" unipolar patterns.
No takes yet. Share an insight, caveat, or question.
Liu et al. (2019) conducted an observational in Right ventricular outflow tract ventricular arrhythmias (n=27). Mini-electrode mapping vs. Conventional ablation catheter mapping was evaluated on Spiky potential durations at the earliest activation site (p=0.001). Mini-electrode mapping of RVOT VAs exhibited significantly shorter spiky potential durations (P=0.001) and increased reverse late potentials (P=0.041) compared with conventional ablation catheters.
Synapse has enriched 10 related papers. Consider them for comparative context: