Insights from the use of multipolar mapping during ablation of supraventricular and ventricular arrhythmias

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Eric D. Braunstein MD , James K. Gabriels MD , Ashkan Ehdaie MD , Jonathan Yarnitsky BSc , Hailei Liu MD, PhD , Archana Ramireddy MD , Xunzhang Wang MD , Michael Shehata MD
{"title":"Insights from the use of multipolar mapping during ablation of supraventricular and ventricular arrhythmias","authors":"Eric D. Braunstein MD ,&nbsp;James K. Gabriels MD ,&nbsp;Ashkan Ehdaie MD ,&nbsp;Jonathan Yarnitsky BSc ,&nbsp;Hailei Liu MD, PhD ,&nbsp;Archana Ramireddy MD ,&nbsp;Xunzhang Wang MD ,&nbsp;Michael Shehata MD","doi":"10.1016/j.hroo.2025.01.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Multipolar mapping, a novel method of electrogram acquisition and annotation distinct from unipolar and bipolar acquisitions, provides orientation-independent near-field signal acquisition with enhanced spatial precision. Multipolar mapping use in humans has not been described.</div></div><div><h3>Objective</h3><div>This study aimed to present findings on the use of multipolar mapping in a variety of different arrhythmia types and mechanisms.</div></div><div><h3>Methods</h3><div>We performed consecutive ablation procedures using a high-density multipolar-capable mapping catheter (OPTRELL, Biosense Webster, Irvine, CA). Parallel mapping using multipolar signal acquisition and conventional bipolar signal acquisition was performed during ablation of various supraventricular and ventricular arrhythmias. Multipolar and bipolar voltage and local activation time maps were compared. A comparison was also made between multipolar, bipolar, and unipolar electrograms in areas of interest.</div></div><div><h3>Results</h3><div>During ablation to treat atrial fibrillation, atrial tachycardia, accessory pathway, premature ventricular contractions, and ventricular tachycardia, we observed 4 advantages of multipolar mapping compared with traditional bipolar mapping: (1) an improved ability to remove far-field signals while preserving the local waveform, (2) wavefront direction independence, (3) a more accurate representation of voltage, and (4) improved ability to identify the origin of focal arrhythmias.</div></div><div><h3>Conclusion</h3><div>In this small observational study of multipolar mapping during ablation of various “real-world” arrhythmias, several advantages of multipolar mapping are demonstrated. Larger studies including evaluation of patient outcomes will help further define the benefit of this novel mapping strategy.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 4","pages":"Pages 402-409"},"PeriodicalIF":2.5000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart Rhythm O2","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666501825000133","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Multipolar mapping, a novel method of electrogram acquisition and annotation distinct from unipolar and bipolar acquisitions, provides orientation-independent near-field signal acquisition with enhanced spatial precision. Multipolar mapping use in humans has not been described.

Objective

This study aimed to present findings on the use of multipolar mapping in a variety of different arrhythmia types and mechanisms.

Methods

We performed consecutive ablation procedures using a high-density multipolar-capable mapping catheter (OPTRELL, Biosense Webster, Irvine, CA). Parallel mapping using multipolar signal acquisition and conventional bipolar signal acquisition was performed during ablation of various supraventricular and ventricular arrhythmias. Multipolar and bipolar voltage and local activation time maps were compared. A comparison was also made between multipolar, bipolar, and unipolar electrograms in areas of interest.

Results

During ablation to treat atrial fibrillation, atrial tachycardia, accessory pathway, premature ventricular contractions, and ventricular tachycardia, we observed 4 advantages of multipolar mapping compared with traditional bipolar mapping: (1) an improved ability to remove far-field signals while preserving the local waveform, (2) wavefront direction independence, (3) a more accurate representation of voltage, and (4) improved ability to identify the origin of focal arrhythmias.

Conclusion

In this small observational study of multipolar mapping during ablation of various “real-world” arrhythmias, several advantages of multipolar mapping are demonstrated. Larger studies including evaluation of patient outcomes will help further define the benefit of this novel mapping strategy.
在室上性和室性心律失常消融过程中使用多极映射的启示
多极映射是一种不同于单极和双极采集的新电图采集和注释方法,它提供了与方向无关的近场信号采集,提高了空间精度。多极映射在人类中的应用尚未被描述。目的探讨多极定位在不同心律失常类型和机制中的应用。方法我们使用高密度多极定位导管(OPTRELL, Biosense Webster, Irvine, CA)进行连续消融手术。在消融各种室上性和室性心律失常期间,使用多极信号采集和传统双极信号采集进行并行测绘。比较多极和双极电压和局部激活时间图。还比较了多极、双极和单极电图在感兴趣的领域。结果在消融治疗心房颤动、房性心动过速、辅助通路、室性早搏和室性心动过速的过程中,我们观察到多极定位与传统双极定位相比有4个优势:(1)在保留局部波形的同时去除远场信号的能力提高;(2)波前方向独立性提高;(3)电压表征更准确;(4)识别局灶性心律失常起源的能力提高。结论在这项小型的观察性研究中,在消融各种“现实世界”心律失常的过程中,多极定位显示了多极定位的几个优点。更大规模的研究,包括对患者结果的评估,将有助于进一步确定这种新型制图策略的益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Heart Rhythm O2
Heart Rhythm O2 Cardiology and Cardiovascular Medicine
CiteScore
3.30
自引率
0.00%
发文量
0
审稿时长
52 days
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信