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Title: | Orthogonal high-density mapping with ventricular tachycardia isthmus analysis vs. pure substrate ventricular tachycardia ablation: A case–control study |
Author: | Vázquez Calvo, Sara Garre Anguera de Sojo, Paz Sánchez Somonte, Paula Borràs, Roger Quinto, Levio Caixal, Gala Pujol López, Margarida Althoff, Till Guasch, Eduard Arbelo, Elena Tolosana, José M. (José María) Brugada Terradellas, Josep, 1958- Mont Girbau, Lluís Roca Luque, Ivo |
Keywords: | Catèters Malalties del cor Estudi de casos Catheters Case studies Heart diseases |
Issue Date: | 1-Aug-2022 |
Publisher: | Frontiers |
Abstract: | Substrate-based ablation has become a successful technique for ventricular tachycardia (VT) ablation. High-density (HD) mapping catheters provide high-resolution electroanatomical maps and better discrimination of local abnormal electrograms. The HD Grid Mapping Catheter is an HD catheter with the ability to map orthogonal signals on top of conventional bipolar signals, which could provide better discrimination of the arrhythmic substrate. On the other hand, conventional mapping techniques, such as activation mapping, when possible, help to identify the isthmus of the tachycardia.The purpose of this study was to compare clinical outcomes after using two different VT ablation strategies: one based on extensive mapping with the HD Grid Mapping Catheter, including VT isthmus analysis, and the other based on pure substrate ablation.Forty consecutive patients undergoing VT ablation with extensive HD mapping method in the hospital clinic (November 2018-November 2019) were included. Clinical outcomes were compared with a historical cohort of 26 consecutive patients who underwent ablation using a scar dechanneling technique before 2018.The density of mapping points was higher in the extensive mapping group (2370.24 ± 920.78 vs. 576.45 ± 294.46; p < 0.001). After 1 year of follow-up, VT recurred in 18.4% of patients in the extensive mapping group vs. 34.6% of patients in the historical control group (p = 0.14), with a significantly greater reduction of VT burden: VT episodes (81.7 ± 7.79 vs. 43.4 ± 19.9%, p < 0.05), antitachycardia pacing (99.45 ± 2.29 vs. 33.9 ± 102.5%, p < 0.001), and implantable cardioverter defibrillator (ICD) shocks (99 ± 4.5 vs. 64.7 ± 59.9%, p = 0.02).The use of a method based on extensive mapping with the HD Grid Mapping Catheter and VT isthmus analysis allows better discrimination of the arrhythmic substrate and could be associated with a greater decrease in VT burden.Copyright © 2022 Vázquez-Calvo, Garre, Sanchez-Somonte, Borras, Quinto, Caixal, Pujol-Lopez, Althoff, Guasch, Arbelo, Tolosana, Brugada, Mont and Roca-Luque. |
Note: | Reproducció del document publicat a: https://doi.org/10.3389/fcvm.2022.912335 |
It is part of: | Frontiers in Cardiovascular Medicine, 2022, vol. 9 |
URI: | http://hdl.handle.net/2445/199586 |
Related resource: | https://doi.org/10.3389/fcvm.2022.912335 |
ISSN: | 2297-055X |
Appears in Collections: | Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) |
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File | Description | Size | Format | |
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Orthogonal high-density mapping with ventricular tachycardia isthmus_FrontiersInCardiovascular.pdf | 3.3 MB | Adobe PDF | View/Open |
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