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":"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","authors":"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","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":"{\"title\":\"Insights from the use of multipolar mapping during ablation of supraventricular and ventricular arrhythmias\",\"authors\":\"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\",\"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}","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}
Insights from the use of multipolar mapping during ablation of supraventricular and ventricular arrhythmias
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.