Comparison of Pentaspline Pulsed Field Ablation Catheter Mapping Modes to Assess Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation

IF 2.4 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Electrophysiology Pub Date : 2026-09-15 Epub Date: 2026-07-19 DOI:10.1111/jce.70408

John L. Fitzgerald, Geoffroy Ditac, Konstantinos Vlachos, Nicolas Johner, Xavier Paul Bouteiller, Kinan Kneizeh, Francesco Notaristefano, Karim Benali, Cinzia Monaco, Marianne T. Langlois, Benjamin Sacristan, Jan Charton, Romain Tixier, Nicolas Derval, Thomas Pambrun, Mélèze Hocini, Michel Haïssaguerre, Josselin Duchateau, Pierre Jaïs, Frédéric Sacher

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引用次数: 0

Abstract

Background

We assessed the electro-anatomic mapping (EAM) capabilities of a pulsed field ablation (PFA) system previously guided by fluoroscopy to assess acquisition modes, and effects of near and far-field signal.

Methods

After pulmonary vein isolation (PVI) proven by pacing to check entrance and exit block, EAM was performed in 2 modes with the Faraview system during CS pacing. Mode 1 utilized bipoles between electrode 3 of each adjacent catheter spline. Mode 2 utilized a pseudo-unipole between electrode 3 and a combination of electrodes 1, 2, and 4 on individual splines. Signals and voltage map demonstration of PVI were compared with pacing assessment. Two observers assessed the maps with a third observer to resolve discrepancies.

Results

Fifteen patients (87% male, aged 58 ± 9 years) had PVI then mapping with the Faraview system. Pacing confirmed isolation of all pulmonary veins. Bipolar mapping (mode 1) displayed multiple apparent PV signals: only 32/61 (52%) of veins appeared isolated. On pseudo-unipolar mapping 59/61 (97%) of veins appeared isolated. The majority of variance in assessment (70.4%) was explainable by the mapping method with minimal variance attributed to observer.

Conclusions

Pseudo-unipolar EAM Faraview mode appears the most accurate for assessment post-PVI compared with bipolar mode.

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Pentaspline脉冲场消融导管定位模式评估阵发性心房颤动肺静脉隔离的比较。

背景：我们评估了脉冲场消融（PFA）系统的电解剖定位（EAM）能力，该系统先前由透视引导，以评估采集模式，以及近场和远场信号的影响。方法：经起搏证实肺静脉隔离（PVI）可检查出入口阻塞后，在CS起搏期间使用Faraview系统分2种模式进行EAM。模式1利用每个相邻导管样条电极3之间的双极。模式2利用电极3和电极1、2和4在单个样条上的组合之间的伪单极。将PVI信号和电压图显示与起搏评估进行比较。两名观察员与第三名观察员对地图进行了评估，以解决差异。结果：15例患者（87%为男性，年龄58±9岁）经Faraview系统定位后出现PVI。起搏确认所有肺静脉隔离双极图（模式1）显示多个明显的PV信号，只有32/61（52%）的静脉出现孤立。在伪单极图上，59/61（97%）的静脉是孤立的。评估中的大部分方差（70.4%）可以用映射法解释，其中归因于观察者的方差最小。结论：与双相模式相比，伪单极EAM Faraview模式对pvi后的评估更为准确。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiovascular Electrophysiology 医学-心血管系统

CiteScore

5.20

自引率

14.80%

发文量

433

审稿时长

3-6 weeks

期刊介绍： Journal of Cardiovascular Electrophysiology (JCE) keeps its readership well informed of the latest developments in the study and management of arrhythmic disorders. Edited by Bradley P. Knight, M.D., and a distinguished international editorial board, JCE is the leading journal devoted to the study of the electrophysiology of the heart.