Multipolar mapping with the high density grid catheter compared with conventional point by point mapping to guide catheter ablation for focal arrhythmias.

2020 
BACKGROUND Multipolar catheters provide high density mapping which may reduce procedural duration and improve success of catheter ablation (CA) for focal arrhythmias. The high density grid (HDG) catheter is a 16 electrode mapping catheter with bipole recordings at orthogonal splines. The aim of this study is to compare the clinical and procedural features from a cohort who underwent CA for focal arrhythmias using multipolar mapping (MPM) with an age and case matched cohort using point by point (PbyP) mapping. METHODS Consecutive patients undergoing CA for focal arrhythmias between October 2018 and January 2020 guided by MPM were compared with PbyP mapping with the ablation catheter over a similar period. Demographics, procedural features and outcomes were compared. RESULTS 54 patients (27 in MPM vs 27 in PbyP mapping) underwent CA for 68 focal arrhythmias (26 atrial and 42 ventricular). In the MPM group the electrogram at the successful site was significantly earlier (39 +/- 11 ms) than in the PbyP group (33 +/- 7 ms; p =0.02). In the MPM group the mapping time (35 +/- 24 mins vs 53 +/- 31 mins in PbyP; p= 0.03) and procedural duration (126 +/- 42 mins vs 153 +/- 39 mins in PbyP, p = 0.02) were significantly shorter. There was no significant difference in radiofrequency and fluoroscopy times, acute procedural success, and arrhythmia recurrence. CONCLUSION Multipolar mapping with the HDG catheter for focal tachycardias identified earlier activation times and was associated with shorter mapping and procedure duration with equivalent success to PbyP mapping. This article is protected by copyright. All rights reserved.
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