Ultra high-density multipolar mapping with double ventricular access: a novel technique for ablation of ventricular tachycardia

Journal of Cardiovascular Electrophysiology
Roderick TungKalyanam Shivkumar

Abstract

Ultra High-Density Multipolar Mapping With Double Ventricular Access. Analogous to the use of circular loop catheters to guide ablation around the pulmonary veins, it may be advantageous to use a multipolar catheter in the ventricle for rapid mapping and to guide ablation. We describe a technique using double access into the left ventricle for multipolar electroanatomic mapping and ablation of scar-mediated ventricular tachycardia (VT). Double access into the left ventricle was obtained via transseptal technique. Endocardial mapping was performed via the first transseptal sheath using a steerable duodecapolar catheter. Higher density mapping was performed in areas of dense scar (<0.5 mV) and border zone (0.5-1.5 mV). All late potentials (LPs) observed on the 20 poles were tagged and pacemapping was performed at these sites for comparison with the clinical or induced VT 12-lead template. If VT was hemodynamically tolerated, entrainment mapping was attempted at sites demonstrating diastolic activity. Ablation was performed through the second transseptal sheath with an open-irrigated catheter at target sites identified by LPs, pacemapping, and/or entrainment on the duodecapolar catheter. Seventeen patients (88% ischemic cardiomyop...Continue Reading

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Citations

Aug 1, 2012·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Paolo Della BellaRoderick Tung
Feb 12, 2014·Current Treatment Options in Cardiovascular Medicine·Zhiyu LingHarikrishna Tandri
Jan 13, 2015·International Journal of Cardiology·Arian SultanDaniel Steven
Dec 19, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Roderick TungKalyanam Shivkumar
Oct 7, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Ricky YuNoel G Boyle
Feb 26, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Jason S BradfieldKalyanam Shivkumar
Jun 3, 2016·Herzschrittmachertherapie & Elektrophysiologie·Sabine ErnstKaren McCarthy
Feb 16, 2012·Circulation. Arrhythmia and Electrophysiology·Roderick TungKalyanam Shivkumar
Oct 29, 2013·Circulation. Arrhythmia and Electrophysiology·Roderick TungKalyanam Shivkumar
Jul 14, 2016·Circulation. Arrhythmia and Electrophysiology·Seigo YamashitaPierre Jaïs
Oct 3, 2012·Circulation·Noel G Boyle, Kalyanam Shivkumar
Mar 21, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Minglong ChenUNKNOWN PAUSE-SCD investigators
May 11, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Edmond M CroninUNKNOWN ESC Scientific Document Group
Jan 14, 2020·Journal of Cardiovascular Electrophysiology·Timothy CampbellSaurabh Kumar
May 23, 2019·Arrhythmia & Electrophysiology Review·Marius AndronacheGraziana Viola
Jan 28, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Edmond M CroninKatja Zeppenfeld
Mar 25, 2018·Current Treatment Options in Cardiovascular Medicine·Zaid Aziz, Roderick Tung
Aug 18, 2020·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Takuro Nishimura, Roderick Tung
Jan 27, 2019·JACC. Clinical Electrophysiology·Masateru TakigawaPierre Jaïs

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