Conti Sergio, Sabatino Francesco, De Blasi Gabriele, Di Stabile Giuseppe, Sgarito Giuseppe
ARNAS Civico Hospital, 90127 Palermo, Italy.
J Cardiovasc Dev Dis. 2022 Jul 22;9(8):232. doi: 10.3390/jcdd9080232.
A high-definition mapping catheter has been introduced, allowing for bipolar recording along and across the spline with a rapid assessment of voltage, activation, and directionality of conduction. We aimed to evaluate differences in mapping density, accuracy, time, and consequently RF time between different mapping catheters used for ventricular tachycardia (VT) ablation. We enrolled consecutive patients undergoing VT ablation at our center. Patients were divided into the LiveWire 2-2-2 mm catheter (group A) and the HD Grid SE (group B). Primary endpoints were total RF delivery time, the number of points acquired in sinus rhythm and VT, and the scar area. Fifty-one patients were enrolled, 22 in group A and 29 in group B. More points were acquired in the Grid group in sinus rhythm (SR) and during VT (2060.78 ± 1600.38 vs. 3278.63 ± 3214.45, p = 0.05; 4201.13 ± 5141.61 vs. 10,569.43 ± 13,644.94, p = 0.02, respectively). The scar area was smaller in group B (Bipolar area, cm2 4.52 ± 2.72 vs. 2.89 ± 2.81, p = 0.05. Unipolar area, cm2 7.47 ± 4.55 vs. 5.56 ± 2.79, p = 0.03). Radiofrequency (RF) time was shorter in the Grid group (30.52 ± 13.94 vs. 22.16 ± 11.03, p = 0.014). LPs and LAVAs were eliminated in overall >93% of patients. No differences were found in terms of arrhythmia-free survival at follow-up. In conclusion, the use of a high-definition mapping catheter was associated with significantly shorter mapping time during VT and RF time. Significantly more points were acquired in SR and during VT. During remap, we also observed more LAVAs and LPs requiring further ablation.
一种高清标测导管已被引入，它能够沿样条并横跨样条进行双极记录，可快速评估电压、激动情况以及传导的方向性。我们旨在评估用于室性心动过速（VT）消融的不同标测导管在标测密度、准确性、时间以及随之而来的射频时间方面的差异。我们纳入了在我们中心接受VT消融的连续患者。患者被分为使用LiveWire 2 - 2 - 2毫米导管的组（A组）和HD Grid SE组（B组）。主要终点为总的射频发放时间、窦性心律和VT时采集的点数以及瘢痕面积。共纳入51例患者，A组22例，B组29例。在窦性心律（SR）和VT期间，Grid组采集的点数更多（分别为2060.78±1600.38对3278.63±3214.45，p = 0.05；4201.13±5141.61对10569.43±13644.94，p = 0.02）。B组的瘢痕面积更小（双极面积，cm² 4.52±2.72对2.89±2.81，p = 0.05。单极面积，cm² 7.47±4.55对5.56±2.79，p = 0.03）。Grid组的射频（RF）时间更短（30.52±13.94对22.16±11.03，p = 0.014）。总体上>93%的患者的局灶性心动过速（LPs）和大折返性房性心动过速（LAVAs）被消除。随访期间在无心律失常生存率方面未发现差异。总之，使用高清标测导管与VT期间显著更短的标测时间和RF时间相关。在SR和VT期间采集的点数显著更多。在重新标测时，我们还观察到更多需要进一步消融的LAVAs和LPs。
