Grid‐mapping catheters versus PentaRay catheters for left atrial mapping on ensite precision mapping system
Jumpei Saito, Kennosuke Yamashita, Takaki Numajiri, Yuma Gibo, Soichiro Usumoto, Syuro Narui, Tatsuki Fujioka, Yu Asukai, Wataru Igawa, Morio Ono, Seitaro Ebara, Toshitaka Okabe, Naoei Isomura, Masahiko Ochiai
Abstract
Abstract Introduction Areas displaying reduced bipolar voltage are defined as low‐voltage areas (LVAs). Moreover, left atrial (LA) LVAs after pulmonary vein isolation (PVI) have been reported as a predictor of recurrent atrial fibrillation (AF). In this study, we compared grid mapping catheter (GMC) with PentaRay catheter (PC) for LA voltage mapping on Ensite Precision mapping system. Methods Twenty‐six consecutive patients with LVAs and border zone within the LA were enrolled. After achieving PVI, voltage mapping under high right atrial pacing for 600 ms was performed twice using each catheter type (GMC first, PC next). Furthermore, LVA was defined as a region with a bipolar voltage of <0.50, and border zone was defined as a region with a bipolar voltage of <1.0, or <1.5 mV. Results Compared with PC, using GMC, voltage mapping contained more mapping points (20 242 [15 859, 26 013] vs. 5589 [4088, 7649]; p < .0001), and more mapping points per minute(1428 [1275, 1803] vs. 558 [372, 783]; p < .0001). In addition, LVA and border zone size using GMC was significantly less than that reported using PC: <1.0 mV (5.9 cm 2 [2.9, 20.2] vs. 13.9 cm 2 [6.3, 24.1], p = .018) and <1.5 mV voltage cutoff (10.6 cm 2 [6.6, 27.2] vs. 21.6 cm 2 [12.6, 35.0], p = .005). Conclusion Bipolar voltage amplitude estimated by GMC was significantly larger than that estimated by PC on Ensite Precision mapping system. GMC may be able to find highly selective identification of LVAs with lower prevalence and smaller LVA and border zone size.