Impact of a high-density grid catheter on long-term outcomes for structural heart disease ventricular tachycardia ablation - Université Paris-Est-Créteil-Val-de-Marne Access content directly
Journal Articles Journal of Interventional Cardiac Electrophysiology Year : 2021

Impact of a high-density grid catheter on long-term outcomes for structural heart disease ventricular tachycardia ablation

Riccardo Proietti
Rory Dowd
  • Function : Author
Lim Ven Gee
  • Function : Author
Shamil Yusuf
  • Function : Author
Sandeep Panikker
  • Function : Author
Sajad Hayat
  • Function : Author
Faizel Osman
  • Function : Author
Kiran Patel
  • Function : Author
Handi Salim
  • Function : Author
Bashar Aldhoon
  • Function : Author
Will Foster
  • Function : Author
Ahmed Merghani
  • Function : Author
Michael Kuehl
  • Function : Author
Prithwish Banerjee
  • Function : Author
Tarvinder Dhanjal
  • Function : Author

Abstract

Abstract Background Substrate mapping has highlighted the importance of targeting diastolic conduction channels and late potentials during ventricular tachycardia (VT) ablation. State-of-the-art multipolar mapping catheters have enhanced mapping capabilities. The purpose of this study was to investigate whether long-term outcomes were improved with the use of a HD Grid mapping catheter combining complementary mapping strategies in patients with structural heart disease VT. Methods Consecutive patients underwent VT ablation assigned to either HD Grid, Pentaray, Duodeca, or point-by-point (PbyP) RF mapping catheters. Clinical endpoints included recurrent anti-tachycardia pacing (ATP), appropriate shock, asymptomatic non-sustained VT, or all-cause death. Results Seventy-three procedures were performed (33 HD Grid, 22 Pentaray, 12 Duodeca, and 6 PbyP) with no significant difference in baseline characteristics. Substrate mapping was performed in 97% of cases. Activation maps were generated in 82% of HD Grid cases (Pentaray 64%; Duodeca 92%; PbyP 33% ( p = 0.025)) with similar trends in entrainment and pace mapping. Elimination of all VTs occurred in 79% of HD Grid cases (Pentaray 55%; Duodeca 83%; PbyP 33% ( p = 0.04)). With a mean follow-up of 372 ± 234 days, freedom from recurrent ATP and shock was 97% and 100% respectively in the HD Grid group (Pentaray 64%, 82%; Duodeca 58%, 83%; PbyP 33%, 33% (log rank p = 0.0042, p = 0.0002)). Conclusions This study highlights a step-wise improvement in survival free from ICD therapies as the density of mapping capability increases. By using a high-density mapping catheter and combining complementary mapping strategies in a strict procedural workflow, long-term clinical outcomes are improved.

Dates and versions

hal-04395436 , version 1 (15-01-2024)

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Cite

Riccardo Proietti, Rory Dowd, Lim Ven Gee, Shamil Yusuf, Sandeep Panikker, et al.. Impact of a high-density grid catheter on long-term outcomes for structural heart disease ventricular tachycardia ablation. Journal of Interventional Cardiac Electrophysiology, 2021, 62 (3), pp.519-529. ⟨10.1007/s10840-020-00918-4⟩. ⟨hal-04395436⟩

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