Grid mapping catheter free#

In this report, a 72-year-old man with a history of symptomatic paroxysmal atrial fibrillation and prior pulmonary vein isolation (PVI) underwent repeat ablation. GREGORY WOO, MD, FHRS, 1 CATHERINE MARKERT, BSBME, CEPS, CCDS, 2 and REBEKAH MONTGOMERY, BSBME, CEPS, CCDS 2ДЎ Cardiovascular Services, Department of Medicine, CaroMont Regional Medical Center, Gastonia, NC, USAДЇollow Catheter ablation of recurrent atrial arrhythmias following pulmonary vein isolation can be challenging given the complex nature of previously ablated tissue, and managing these already complex cases may be rendered more difficult by the impact of wavefront directionality on mapping catheter orientation, which can make the accurate identification of arrhythmogenic substrate more difficult to achieve. This case highlights the advantages of using the Advisorв„ў HD Grid mapping catheter for the identification of deceleration zones in areas of low voltage during ischemic VT ablation.A Direction-independent, High-density Mapping Catheter Provides Electrophysiological Advantage in Complex Atrial Tachycardia Ablation Following Pulmonary Vein Isolation The blue line represents the late potential area. Video 1 : Sparkle map with the propagation wavefront revealing a channel inside the low-voltage area (yellow line) and coincident with the deceleration zone. The yellow line represents the low-voltage area and the blue line indicates the late potential area. B: An isochronal late activation map, with eight equally distributed activation isochrones and with a deceleration zone as visualized by the presence of more than 3 isochrones in a 1-cm radius and, demonstrated in the electrograms. In between, yellow, green, and blue coloring represent transition areas. The gray coloring indicates areas of probable scar defined as electrogram voltage below 0.5 mV and the purple coloring indicates areas of voltage above 1.5 mV.

Grid mapping catheter free#

After one year of follow-up, the patient remained free of shocks despite the absence of antiarrhythmic drug therapy.ДЇigure 1: A: An LV bipolar map. After ablation, a new map was created, confirming the absence of deceleration zones and local abnormal ventricular activity potentials. Radiofrequency was delivered in the deceleration zone and also with the goal of eliminating all local abnormal ventricular activity potentials. The sparkle propagation map revealed a possible channel in the low-voltage area ( Video 1 ) coincident with the deceleration zone. The visualization of some electrograms with an amplitude as low as 0.03 mV was only possible due to the smaller electrodes with closer interelectrode spacing present in the Advisorв„ў HD Grid mapping catheter. Left ventricle bipolar mapping was performed with the Advisorв„ў HD Grid Mapping Catheter, Sensor Enabledв„ў, while pacing from the right ventricle, and revealed a large area of low voltage ( 3 isochrones within a 1-cm radius) inside the low-voltage area ( Figure 1B). The transthoracic echocardiogram revealed a dilated left ventricle with an estimated ejection fraction of 36%, with an aneurism observed in the inferior wall. There was no documentation of VT on the 12-lead electrocardiogram. He had a previous history of coronary artery disease with a cardiac resynchronization therapy defibrillator implanted for secondary prevention, renal insufficiency, and persistent atrial fibrillation. Email: 72-year-old male was referred for ventricular tachycardia (VT) ablation due to recurrent episodes of shock despite amiodarone therapy. Jude/Abbott.ДЄddress correspondence to: Pedro A. Souza reports the receipt of speaker fees from Biosense Webster, Boston Scientific, Medtronic, and St. High-density Grid Mapping Catheter Unveiled a Deceleration Zone in a Large Ventricular ScarДЎ Pacing & Electrophysiology Department, Centro Hospitalar e UniversitГЎrio de Coimbra, Coimbra, PortugalДЇollow Deceleration zone, high-density grid, ventricular tachycardia.Дr.