Does the FIRMap basket catheter improve left atrial coverage and tissue contact compared to the Constellation catheter in patients undergoing ablation for AT/AF?
The FIRMap basket catheter provides superior left atrial coverage and tissue contact compared to the Constellation catheter, and mapping is further optimized by appropriate catheter positioning and selecting patients without severely dilated or scarred atria.
Abstract Introduction Panoramic mapping with basket catheters has been used to map atrial fibrillation (AF). However, the limited tissue contact and coverage achieved has raised concerns. Methods and Results Patients undergoing catheter ablation for atrial tachycardia (AT) and persistent AF were recruited. Unipolar signals were recorded with the Constellation or FIRMap catheters. The proportion and distribution of anatomical coverage by the catheters was determined and tissue contact achieved measured. The impact of catheter position, left atrium (LA) size, and bipolar voltage were evaluated. Forty patients were recruited (20 Constellation and 20 FIRMap). The LA coverage achieved with the FIRMap catheter compared to the Constellation catheter was greater (76.9 ± 12.9% vs. 50.8 ± 10.3%; P 30 cm 2 and mean bipolar voltage of <0.3 mV was associated with reduction in coverage and contact (both P < 0.001). There was a significant difference in AT/AF freedom during follow‐up in the FIRMap versus Constellation group (13/13 vs. 8/12; P = 0.04). Conclusions The FIRMap is superior to the Constellation catheter in terms of LA coverage and contact. Optimizing catheter position and appropriate patient selection based on no more than moderately dilated or scarred atria will also facilitate mapping with basket catheters.
Honarbakhsh et al. (2017) studied this question.