Cardiac mapping with good contact force significantly increased the detection of late potentials compared to poor contact (23.2% vs 11.9%; P<0.0001), improving substrate characterization.
Observational (n=17)
Does sufficient contact force during cardiac mapping improve substrate characterization in patients with ventricular tachycardia?
Maintaining a contact force of at least 9 g during ventricular mapping improves substrate characterization and detection of late potentials in patients with ventricular tachycardia.
Absolute Event Rate: 23.2% vs 11.9%
p-value: p=<0.0001
BACKGROUND: Although the importance of contact force monitoring during mapping and ablation procedures is widely recognized, only indirect measurements have been validated. METHODS: Real-time force values were measured using the force-sensing catheter and electroanatomical mapping system from 27 chambers (13 LVs, 6 RVs, and 8 epicardial space) in 17 patients affected by ventricular tachycardia. Left ventricular mapping was performed by the transaortic approach in all patients and in 5 patients also by a transseptal approach with the aid of a deflectable sheath. All points were divided into 2 groups according to the presence of positive contact force during diastole: good and poor contact. The frequency of good contact and its impact on electrophysiological parameters such as signal amplitude, local impedance, and frequency of late potentials was evaluated. The best cut-off value to discriminate the 2 groups was calculated by a generalized linear mixed-effects model. RESULTS: Among all 5,926 points, 1,566 (26%) points were taken with poor contact. In healthy tissue, categorical increase of contact force caused the increase of unipolar and bipolar signal potential amplitude followed by plateau. The frequency of late potentials in the poor contact group was significantly lower when compared to the good contact group (11.9 vs 23.2%; P < 0.0001). The best cut-off force value to predict good contact during left ventricular endocardial and epicardial mappings was 9 g. CONCLUSIONS: A combined transaortic and transseptal approach allows better endocardial contact during left ventricular mapping. Ventricular mapping with sufficient contact force produces better substrate characterization within pathological areas.
Mizuno et al. (Mon,) conducted a observational in Ventricular tachycardia (n=17). Good contact force during mapping vs. Poor contact force was evaluated on Frequency of late potentials (p=<0.0001). Cardiac mapping with good contact force significantly increased the detection of late potentials compared to poor contact (23.2% vs 11.9%; P<0.0001), improving substrate characterization.