Effect of Interelectrode Spacing on Measurements of Purkinje Potential During Fascicular Ventricular Tachycardia

Naeemah, Qasim J.; Nogami, Akihiko; Komatsu, Yuki; Oda, Yuka; Phanthawimol, Wipat; Yamasaki, Hiro; Igarashi, Miyako; Aonuma, Kazutaka; Ieda, Masaki

doi:10.1016/j.jacep.2022.01.008

Cited by 2 publications

(4 citation statements)

References 3 publications

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“…The macro‐reentrant circuit and its critical component of FVT have been elucidated, and late diastolic P1 is a well‐accepted ablation target of FVT 9 . However, it has been reported that P1 could not be recorded in 25% of cases when mapped by a mapping and ablation catheter and in 36%−66% of cases when mapped by linear multi‐electrode catheters 9,11,18 . In the present study, P1 could not be recorded in 22% of the cases by a mapping and ablation catheter and at least 33% of the cases by a Livewire catheter.…”

Section: Discussioncontrasting

confidence: 64%

“…9 However, it has been reported that P1 could not be recorded in 25% of cases when mapped by a mapping and ablation catheter and in 36%−66% of cases when mapped by linear multi-electrode catheters. 9,11,18 In the present study, P1 could not be recorded in 22% of the cases by a mapping and ablation catheter and at least 33% of the cases by a Livewire catheter. In contrast, the PentaRay catheter could reproducibly reveal P1 in consecutive 9 FVTs.…”

Section: Discussioncontrasting

confidence: 61%

“…20 Moreover, since PP is a specific potential of thin and insulated Purkinje fibers as well as a near-field potential, any advantage in wide-paired electrodes of the PentaRay catheter have not been apparently observed. In contrast to linear catheters, for which wide-paired electrodes recorded bigger P1, 18 the PentaRay catheter has radiating fine and flexible splines and could contact subendocardial Purkinje fibers more directly, thereby recording far-field potentials is thought to be less important. In addition, wide spacing may rather offset the advantages of small electrodes of the PentaRay catheter particularly in mapping of Purkinje fibers, 17 which warrants further investigation.…”

Section: Discussionmentioning

confidence: 99%

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Mapping of Purkinje‐related ventricular arrhythmias by a multispline catheter with small and close‐paired electrodes: Comparison with conventional catheters

Takase,

Mukai,

Nagaoka

et al. 2023

Pacing Clinical Electrophis

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BackgroundPrecise mapping of the Purkinje fiber network is essential in catheter ablation of Purkinje‐related ventricular arrhythmias (PrVAs). We sought to evaluate the mapping ability of a multi‐spline duodecapolar catheter (PentaRay) for PrVAs.MethodsMappings of Purkinje fibers by PentaRay catheters were compared with those by conventional mapping catheters in consecutive patients undergoing catheter ablation of PrVAs from 2015 to 2022.ResultsSixteen PrVAs (7 premature ventricular contractions or non‐reentrant fascicular tachycardias [PVCs/NRFTs] and 9 fascicular ventricular tachycardias [FVTs]) were retrospectively studied. In PVCs/NRFTs, earliest preceding Purkinje potentials (PPs) could be recorded by the PentaRay catheters but not by the mapping and ablation catheters in 5 cases. At the earliest PP sites, the precedence from the QRS onset was greater, and the amplitude of the preceding potentials was higher in the PentaRay catheter compared with those in the mapping and ablation catheter (−62.0 ± 42.8 vs. −29.4 ± 34.2 ms, P = 0.02; 0.45 ± 0.43 vs. 0.09 ± 0.08 mV, P = 0.02). In FVTs, late diastolic potentials (P1) were recorded by the PentaRay catheters but not by the mapping and ablation catheters or the linear duodecapolar catheter in 2 cases. The amplitude of P1 was higher in the PentaRay catheter compared with that in the linear duodecapolar catheter and the mapping and ablation catheters (0.72 ± 0.49 vs. 0.17 ± 0.18 vs. 0.27 ± 0.21 mV, P = 0.0006, P = 0.002). The localized critical PPs, defined as the earliest preceding potentials in PVCs/NRFTs and P1 in FVTs, could be recorded in all the patients by the PentaRay catheter. The mapping ability of critical PPs of PrVAs was better with the PentaRay catheter than with the conventional mapping catheters (16/16 vs. 9/16, P = 0.004 by McNemar exact test).ConclusionsThe PentaRay catheter has clinical advantages in mapping of the Purkinje fiber network to reveal critical PPs as ablation targets of PrVAs.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

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Mapping of Purkinje‐related ventricular arrhythmias by a multispline catheter with small and close‐paired electrodes: Comparison with conventional catheters

Takase,

Mukai,

Nagaoka

et al. 2023

Pacing Clinical Electrophis

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“…First of all, it has been reported that bipolar potentials with a wide interelectrode spacing cover a large area, making it easier to detect abnormal potentials on the endocardial side. Naeemah and colleagues 6 reported that a wide bipolar spacing is able to record larger abnormal potentials in fascicular VT with arrhythmias originating from the superficial endocardial layer and described the usefulness of a linear decapolar catheter.…”

Section: Discussionmentioning

confidence: 99%

A case of ventricular tachycardia with an intramural excitable substrate detected by evaluating the close and the wide bipolar electrograms of a linear decapolar catheter

Kanda¹,

Minamiguchi²,

Makino³

et al. 2023

HeartRhythm Case Reports

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Effect of Interelectrode Spacing on Measurements of Purkinje Potential During Fascicular Ventricular Tachycardia

Cited by 2 publications

References 3 publications

Mapping of Purkinje‐related ventricular arrhythmias by a multispline catheter with small and close‐paired electrodes: Comparison with conventional catheters

Mapping of Purkinje‐related ventricular arrhythmias by a multispline catheter with small and close‐paired electrodes: Comparison with conventional catheters

A case of ventricular tachycardia with an intramural excitable substrate detected by evaluating the close and the wide bipolar electrograms of a linear decapolar catheter

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