An early multicenter experience of the novel high-density star-shaped mapping catheter in complex arrhythmias

Sarkozy, Andrea; Vijgen, Johan; Potter, Tom De; Schilling, Richard J.; Markides, Vias

doi:10.1007/s10840-022-01176-2

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…In comparison to other panoramic mapping systems, the CartoFinder system created global activation propagation maps using local activation times obtained through annotation of atrial signals 12,16,17,30 . Combined with the use of recently developed high‐density diagnostic catheters and identification of appropriate patients to avoid over‐ablation, CartoFinder had the potential to provide an effective patient‐specific ablation target based on high‐resolution AF activation maps of the RA and LA 11,16,17,32,33 …”

Section: Discussionmentioning

confidence: 99%

“…12,16,17,30 Combined with the use of recently developed highdensity diagnostic catheters and identification of appropriate patients to avoid over-ablation, CartoFinder had the potential to provide an effective patient-specific ablation target based on high-resolution AF activation maps of the RA and LA. 11,16,17,32,33 Study limitations included the fact that this was a non-randomized, non-blinded study. In addition, as the study was conducted with an ear-…”

Section: Discussionmentioning

confidence: 99%

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Safety and efficacy of catheter ablation on patients with persistent atrial fibrillation by targeting repetitive activation patterns and focal impulses

Potter

Sarkozy

Duytschaever

et al. 2023

Pacing Clinical Electrophis

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Background The study is intended to evaluate the acute and long‐term effectiveness and peri‐procedural safety in ablation of persistent atrial fibrillation (PsAF) using the CartoFinder algorithm guided ablation (CFGA) targeting on repetitive activation patterns (RAPs) and focal impulses (FIs) identified in dynamic maps. Methods This is a prospective, single‐arm, multicenter study. A 64‐pole multielectrode basket catheter was used for intracardiac global electrogram (EGM) mapping. The RAPs or FIs were repeatedly mapped and ablated for up to five iterations by the CartoFinder algorithm to achieve sinus rhythm (SR) or organized atrial tachycardia (AT), which were followed by PVI. All patients were followed up for 12 months after procedure. Results Sixty‐four PsAF patients (age, 60.7 ± 9.1 years; male, 76.6%; median PsAF duration, 6.0 months) underwent CFGA on RAPs/FIs. Six patients (9.4%) reported primary adverse event (PAE) including groin hematoma (2), complete heart block (1), tamponade (1), pericarditis (1), and pseudoaneurysm (1). Repeated mapping and ablation on RAPs/FIs resulted in the cycle length (CL) increase from 191.0 ± 167.6 ms at baseline to 365.7 ± 296.7 ms in the LA and from 167.8 ± 41.6 ms to 379.4 ± 293.5 ms in the RA and 30.2% (19/63) AF termination to SR or organized AT. The 12‐month arrhythmia‐free and symptomatic AF‐free rates were 60.9% and 75.0%, respectively. Patients with acute AF termination showed a higher 12‐month arrhythmia‐free rate (76.9%) than those without (50.0%, p = .04). Conclusions The study demonstrated that the CartoFinder algorithm can be used for global activation mapping during PsAF ablation. Patients with acute AF termination had a lower 12‐month AF recurrence rate compared to patients without.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of catheter ablation on patients with persistent atrial fibrillation by targeting repetitive activation patterns and focal impulses

Potter

Sarkozy

Duytschaever

et al. 2023

Pacing Clinical Electrophis

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“…However, to avoid any misleading interpretation of the underlying circuit, accurate and high-density mapping of investigated atrial chambers is required to account for almost 90% of the tachycardia cycle length and thereby avoiding missing mapping segments potentially due to non-annotated low-amplitude and fragmented electrograms as low as 0.03–0.05 mV [ 27 ]. In this setting, the recent development of new tools, such as Octaray TM system (Biosense Webster Inc., Irvine, CA, USA) and the Ensite TM Omnipolar Technology (OT) (Abbott, Chicago, IL, USA) might allow for even better results [ 62 , 63 , 64 ], provided that the multitude of signals collected is correctly acquired and interpreted.…”

Section: The Winding Path To Improve the Procedures And The Overall C...mentioning

confidence: 99%

Procedural Feasibility and Long-Term Efficacy of Catheter Ablation of Atypical Atrial Flutters in a Wide Spectrum of Heart Diseases: An Updated Clinical Overview

Ponti

Marazzi²,

Vilotta³

et al. 2022

JCM

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Atypical atrial flutters (AAFL) are difficult-to-manage atrial arrhythmias, yet potentially amenable to effective radiofrequency catheter ablation (CA). However, data on CA feasibility are only sparingly reported in the literature in different clinical settings, such as AAFL related to surgical correction of congenital heart disease. The aim of this review was to provide an overview of the clinical settings in which AAFL may occur to help the cardiac electrophysiologist in the prediction of the tachycardia circuit location before CA. Moreover, the role and proper implementation of cutting-edge technologies in this setting were investigated as well as which procedural and clinical factors are associated with long-term failure to maintain sinus rhythm (SR) to find out which patients may, or may not, benefit from this procedure. Not only different surgical and non-surgical scenarios are associated with peculiar anatomical location of AAFL, but we also found that CA of AAFL is generally feasible. The success rate may be as low as 50% in surgically corrected congenital heart disease (CHD) patients but up to about 90% on average after pulmonary vein isolation (PVI) or in patients without structural heart disease. Over the years, the progressive implementation of three-dimensional mapping systems and high-density mapping tools has also proved helpful for ablation of these macro-reentrant circuits. However, the long-term maintenance of SR may still be suboptimal due to the progressive electroanatomic atrial remodeling occurring after cardiac surgery or other interventional procedures, thus limiting the likelihood of successful ablation in specific clinical settings.

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“…Recently, a new OCTARAY ® mapping catheter (Biosense Webster, Diamond Bar, CA, USA) was commercially launched. 6,7 This OCTARAY catheter has 48 electrodes arranged on eight radiating splines, and is an improved version of PENTARAY ® catheter (Biosense Webster) which has 20 electrodes arranged on five5 radiating splines. The new catheter is designed to enable rapid, high-density mapping, with precise signal recording via the small electrodes and improved unipolar signal quality due to the indifferent electrode located at the center of radiating splines.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, a new OCTARAY ® mapping catheter (Biosense Webster, Diamond Bar, CA, USA) was commercially launched 6,7 . This OCTARAY catheter has 48 electrodes arranged on eight radiating splines, and is an improved version of PENTARAY ® catheter (Biosense Webster) which has 20 electrodes arranged on five5 radiating splines.…”

Section: Introductionmentioning

confidence: 99%

Comparison of voltage maps using OCTARAY catheter and PENTARAY catheter

Masuda,

Matsuda,

Uematsu

et al. 2023

Pacing Clinical Electrophis

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BackgroundRecently, a new OCTARAY® mapping catheter was commercially launched. The catheter is designed to enable high‐density mapping and precise signal recording via 48 small electrodes arranged on eight radiating splines. The purpose of this study was to compare bipolar voltage and low‐voltage‐area size, and mapping efficacy between the OCTARAY catheter and the PENTARAY® catheterMethodsTwelve consecutive patients who underwent initial and second ablations for persistent atrial fibrillation within 2 years were considered for enrollment. Voltage mapping was performed twice, first during the initial ablation using the PENTARY catheter and second during the second ablation using the OCTARAY Long 3‐3‐3‐3‐3 (L3) catheter.ResultsMean voltage with the OCTARAY‐L3 catheter (1.64 ± 0.57 mV) was 32.3% greater than that with the PENTARAY catheter (1.24 ± 0.46 mV, p < .0001) in total left atrium. Low‐voltage‐area (<0.50 mV) size with the OCTARAY‐L3 catheter was smaller than that with the PENTARAY catheter (6.9 ± 9.7 vs. 11.4 ± 13.0 cm2, p < .0001). The OCTARAY‐L3 catheter demonstrated greater efficacy than the PENTARAY catheter in terms of shorter mapping time (606 ± 99 vs. 782 ± 211 s, p = .008) and more mapping points (3,026 ± 838 vs. 781 ± 342 points, p < .0001).ConclusionThe OCTARAY catheter demonstrated higher voltage recordings, narrower low‐voltage areas, and a more efficacious mapping procedure than the PENTARAY catheter.

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An early multicenter experience of the novel high-density star-shaped mapping catheter in complex arrhythmias

Cited by 4 publications

References 18 publications

Safety and efficacy of catheter ablation on patients with persistent atrial fibrillation by targeting repetitive activation patterns and focal impulses

Safety and efficacy of catheter ablation on patients with persistent atrial fibrillation by targeting repetitive activation patterns and focal impulses

Procedural Feasibility and Long-Term Efficacy of Catheter Ablation of Atypical Atrial Flutters in a Wide Spectrum of Heart Diseases: An Updated Clinical Overview

Comparison of voltage maps using OCTARAY catheter and PENTARAY catheter

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