Rapid Mapping of Right Atrial Tachycardia Using a New Multielectrode Basket Catheter.
BACKGROUND
The mapping of atrial tachycardia (AT) can often be challenging and time-consuming, especially in patients with ATs that develop following cardiac surgery or are concomitant with atrial fibrillation. Recently, a new multielectrode basket catheter (MBC) has become available; we hypothesized that the MBC could be utilized to diagnose AT circuits.


RESULTS
This study included 51 consecutive patients undergoing catheter ablation of clinically documented right-sided ATs (including 17 cases following cardiac surgery). Using a NavX system, 2 activation maps of the ATs were created, one using the new MBC (32 mm, 31 poles) and the other using a circular catheter. The time needed to complete the activation maps and the points acquired with both mapping catheters were compared. In all 64 ATs, including 34 non-cavotricuspid isthmus-dependent ATs, the AT activation maps created by both catheters were essentially identical. The number of points acquired to complete the activation maps did not differ significantly between the MBC and the circular catheter (387 [285-511] vs. 374 [269-533], P = 0.19), but the mapping time was significantly shorter using the MBC (4.0 [3.0-6.0] minutes vs. 8.0 [6.5-10.0] minutes, P < 0.0001). Inadvertent mechanical AT termination (n = 6) was observed only during mapping with the circular catheter.


CONCLUSIONS
In patients with right-sided ATs, the use of an MBC could save mapping time.
Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.|Department of Cardiovascular Medicine, Hokkaido University, Sapporo, Japan.
Kenji
K
Okubo
Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
Taishi
T
Kuwahara
Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
Katsumasa
K
Takagi
Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
Masateru
M
Takigawa
Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
Jun
J
Nakajima
Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
Yuji
Y
Watari
Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
Emiko
E
Nakashima
Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
Kazuya
K
Yamao
Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
Tadashi
T
Fujino
Department of Cardiovascular Medicine, Hokkaido University, Sapporo, Japan.
Hiroyuki
H
Tsutsui
Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
Atsushi
A
Takahashi
D000200:Action Potentials; D000368:Aged; D016280:Atrial Function, Right; D006328:Cardiac Catheterization / Q000295:instrumentation*; D062906:Cardiac Catheters; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation / Q000295:instrumentation; D022062:Electrophysiologic Techniques, Cardiac / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006325:Heart Atria / Q000503:physiopathology* / Q000601:surgery; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D013617:Tachycardia, Supraventricular / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery
arrhythmia; atrial tachycardia; catheter ablation; mapping; multielectrode basket catheter