Cardiovascular Division, Department of Medicine, Deaconess Medical Center, Harvard Medical School, Harvard-Thorndike Electrophysiology Institute, Boston, Massachusetts.
Research and Development, Biosense Webster, Irwindale, California.
J Cardiovasc Electrophysiol. 2019 May;30(5):749-757. doi: 10.1111/jce.13867. Epub 2019 Feb 12.
Multielectrode mapping catheters improve the ability to map within the heterogeneous scar. A novel Octaray catheter with eight spines and 48 electrodes may further improve the speed and resolution of atrial mapping. The aims of this study were to (1) establish the Octaray's baseline mapping performance and electrogram (EGM) characteristics in healthy atria and to (2) determine its utility for identifying gaps in a swine model of atrial ablation lines.
The right atria of eight healthy swine were mapped with Octaray and Pentaray catheters (Biosense Webster, Irvine, CA) before and after the creation of ablation lines with intentional gaps. Baseline mapping characteristics including EGM amplitude, duration, number of EGMs, and mapping time were compared. Postablation maps were created and EGM characteristics of continuous lines and gaps were correlated with pathology. Compared with Pentaray, the Octaray collected more EGMs per map (2178 ± 637 vs 1046 ± 238; P < 0.001) at a shorter mapping duration (3.2 ± 0.79 vs 6.9 ± 2.67 minutes; P < 0.001). In healthy atria, the Octaray recorded lower bipolar voltage amplitude (1.96 ± 1.83 mV vs 2.41 ± 1.92 mV; P < 0.001) while ablation gaps were characterized by higher voltage amplitude (1.24 ± 1.12 mV vs 1.04 ± 1.27 mV; P < 0.001). Ablation gaps were similarly identified by both catheters (P = 1.0). The frequency of "false gaps," defined as intact ablation lines with increased voltage amplitude was more common with Pentaray (6 vs 2) and resulted from erroneous annotation of far-field EGMs.
The Octaray increases the mapping speed and density compared with the Pentaray catheter. It is as sensitive for identifying ablation gaps and more specific for mapping intact ablation lines.
多电极标测导管提高了在异质性瘢痕内标测的能力。一种新型的八脊 Octaray 导管，具有 8 个脊和 48 个电极，可能进一步提高心房标测的速度和分辨率。本研究的目的是：(1) 确定 Octaray 在健康心房中的基线标测性能和电图 (EGM) 特征；(2) 确定其在猪心房消融线模型中识别间隙的用途。
在创建有意留有间隙的消融线之前和之后，用 Octaray 和 Pentaray 导管（Biosense Webster，Irvine，CA）对 8 头健康猪的右心房进行了标测。比较了基线标测特征，包括 EGM 幅度、持续时间、EGM 数量和标测时间。创建了消融后图谱，并将连续线和间隙的 EGM 特征与病理学相关联。与 Pentaray 相比，Octaray 每幅图采集的 EGM 更多（2178±637 比 1046±238；P<0.001），标测时间更短（3.2±0.79 比 6.9±2.67 分钟；P<0.001）。在健康心房中，Octaray 记录的双极电压幅度较低（1.96±1.83 mV 比 2.41±1.92 mV；P<0.001），而消融间隙的电压幅度较高（1.24±1.12 mV 比 1.04±1.27 mV；P<0.001）。两种导管都能很好地识别消融间隙（P=1.0）。电压幅度增加的“假间隙”的频率（定义为有完整消融线）用 Pentaray 更常见（6 比 2），这是由于远场 EGM 的错误注释所致。
与 Pentaray 导管相比，Octaray 提高了标测速度和密度。它对识别消融间隙同样敏感，对标记完整的消融线更具特异性。
