Transcutaneous multielectrode basket catheter for endocardial mapping and ablation of ventricular tachycardia in the pig

Michael Eldar, Dan G. Ohad, Jeffrey Goldberger, Zeev Rotstein, Steve Hsu, David K. Swanson, Arnold J. Greenspon

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background: Endocardial mapping using standard electrode catheters is often technically limited in ventricular tachycardia and constitutes a major obstacle to successful ablation. We wished to examine the utility of a basket-shaped multielectrode mapping catheter (MMC) in the mapping and ablation of ventricular tachycardia. Methods and Results: This study of sustained monomorphic ventricular tachycardia (SMVT) was conducted in two phases in the postinfarction pig model. In the first phase, the utility of the MMC in providing adequate localization of potential ablation site(s) of SMVT by different techniques (presystolic potentials, pace mapping, and concealed entrainment) was assessed in 21 pigs. In the second phase, ablution of induced SMVT was attempted in 10 pigs. Mapping of SMVT was performed after percutaneous introduction of the MMC to the LV. Comprehensive mapping was performed in 90 episodes of SMVT and required 2.0 to 25 seconds. Diastolic potentials were recorded during 86 episodes; good or identical pace maps (≤9 of 12 paced surface ECG leads identical to ventricular tachycardia surface ECG leads) were obtained in 25 of 31 maps, and entrainment was achieved during 28 of 42 SMVTs. In 10 pigs, 10 SMVTs were recorded at least twice and were considered for radiofrequency ablation. An 8-mm tip ablation catheter was advanced to potential ablation sites with a specially designed 'homing' device, requiring a median time of 120 seconds. In these 10 pigs, either identical pace map (≤11 of 12, 6 SMVTs) or concealed entrainment (4 SMVTs) guided the ablation procedure. After ablation, 8 of 10 SMVTs were rendered noninducible, while 2 pigs died during energy application of degeneration of SMVT to ventricular fibrillation. Conclusion: The MMC allows rapid, comprehensive, and reliable endocardial mapping during SMVTs, which facilitates successful ablation in the porcine post-myocardial infarction model.

Original languageEnglish (US)
Pages (from-to)2430-2437
Number of pages8
JournalCirculation
Volume96
Issue number7
DOIs
StatePublished - Oct 7 1997
Externally publishedYes

Fingerprint

Ventricular Tachycardia
Swine
Catheters
Electrocardiography
Catheter Ablation
Ventricular Fibrillation
Electrodes
Myocardial Infarction
Equipment and Supplies

Keywords

  • Ablation
  • Endocardium
  • Mapping
  • Tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Transcutaneous multielectrode basket catheter for endocardial mapping and ablation of ventricular tachycardia in the pig. / Eldar, Michael; Ohad, Dan G.; Goldberger, Jeffrey; Rotstein, Zeev; Hsu, Steve; Swanson, David K.; Greenspon, Arnold J.

In: Circulation, Vol. 96, No. 7, 07.10.1997, p. 2430-2437.

Research output: Contribution to journalArticle

Eldar, Michael ; Ohad, Dan G. ; Goldberger, Jeffrey ; Rotstein, Zeev ; Hsu, Steve ; Swanson, David K. ; Greenspon, Arnold J. / Transcutaneous multielectrode basket catheter for endocardial mapping and ablation of ventricular tachycardia in the pig. In: Circulation. 1997 ; Vol. 96, No. 7. pp. 2430-2437.
@article{466ff69c73a24347af10982f9f0cf3ab,
title = "Transcutaneous multielectrode basket catheter for endocardial mapping and ablation of ventricular tachycardia in the pig",
abstract = "Background: Endocardial mapping using standard electrode catheters is often technically limited in ventricular tachycardia and constitutes a major obstacle to successful ablation. We wished to examine the utility of a basket-shaped multielectrode mapping catheter (MMC) in the mapping and ablation of ventricular tachycardia. Methods and Results: This study of sustained monomorphic ventricular tachycardia (SMVT) was conducted in two phases in the postinfarction pig model. In the first phase, the utility of the MMC in providing adequate localization of potential ablation site(s) of SMVT by different techniques (presystolic potentials, pace mapping, and concealed entrainment) was assessed in 21 pigs. In the second phase, ablution of induced SMVT was attempted in 10 pigs. Mapping of SMVT was performed after percutaneous introduction of the MMC to the LV. Comprehensive mapping was performed in 90 episodes of SMVT and required 2.0 to 25 seconds. Diastolic potentials were recorded during 86 episodes; good or identical pace maps (≤9 of 12 paced surface ECG leads identical to ventricular tachycardia surface ECG leads) were obtained in 25 of 31 maps, and entrainment was achieved during 28 of 42 SMVTs. In 10 pigs, 10 SMVTs were recorded at least twice and were considered for radiofrequency ablation. An 8-mm tip ablation catheter was advanced to potential ablation sites with a specially designed 'homing' device, requiring a median time of 120 seconds. In these 10 pigs, either identical pace map (≤11 of 12, 6 SMVTs) or concealed entrainment (4 SMVTs) guided the ablation procedure. After ablation, 8 of 10 SMVTs were rendered noninducible, while 2 pigs died during energy application of degeneration of SMVT to ventricular fibrillation. Conclusion: The MMC allows rapid, comprehensive, and reliable endocardial mapping during SMVTs, which facilitates successful ablation in the porcine post-myocardial infarction model.",
keywords = "Ablation, Endocardium, Mapping, Tachycardia",
author = "Michael Eldar and Ohad, {Dan G.} and Jeffrey Goldberger and Zeev Rotstein and Steve Hsu and Swanson, {David K.} and Greenspon, {Arnold J.}",
year = "1997",
month = "10",
day = "7",
doi = "10.1161/01.CIR.96.7.2430",
language = "English (US)",
volume = "96",
pages = "2430--2437",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Transcutaneous multielectrode basket catheter for endocardial mapping and ablation of ventricular tachycardia in the pig

AU - Eldar, Michael

AU - Ohad, Dan G.

AU - Goldberger, Jeffrey

AU - Rotstein, Zeev

AU - Hsu, Steve

AU - Swanson, David K.

AU - Greenspon, Arnold J.

PY - 1997/10/7

Y1 - 1997/10/7

N2 - Background: Endocardial mapping using standard electrode catheters is often technically limited in ventricular tachycardia and constitutes a major obstacle to successful ablation. We wished to examine the utility of a basket-shaped multielectrode mapping catheter (MMC) in the mapping and ablation of ventricular tachycardia. Methods and Results: This study of sustained monomorphic ventricular tachycardia (SMVT) was conducted in two phases in the postinfarction pig model. In the first phase, the utility of the MMC in providing adequate localization of potential ablation site(s) of SMVT by different techniques (presystolic potentials, pace mapping, and concealed entrainment) was assessed in 21 pigs. In the second phase, ablution of induced SMVT was attempted in 10 pigs. Mapping of SMVT was performed after percutaneous introduction of the MMC to the LV. Comprehensive mapping was performed in 90 episodes of SMVT and required 2.0 to 25 seconds. Diastolic potentials were recorded during 86 episodes; good or identical pace maps (≤9 of 12 paced surface ECG leads identical to ventricular tachycardia surface ECG leads) were obtained in 25 of 31 maps, and entrainment was achieved during 28 of 42 SMVTs. In 10 pigs, 10 SMVTs were recorded at least twice and were considered for radiofrequency ablation. An 8-mm tip ablation catheter was advanced to potential ablation sites with a specially designed 'homing' device, requiring a median time of 120 seconds. In these 10 pigs, either identical pace map (≤11 of 12, 6 SMVTs) or concealed entrainment (4 SMVTs) guided the ablation procedure. After ablation, 8 of 10 SMVTs were rendered noninducible, while 2 pigs died during energy application of degeneration of SMVT to ventricular fibrillation. Conclusion: The MMC allows rapid, comprehensive, and reliable endocardial mapping during SMVTs, which facilitates successful ablation in the porcine post-myocardial infarction model.

AB - Background: Endocardial mapping using standard electrode catheters is often technically limited in ventricular tachycardia and constitutes a major obstacle to successful ablation. We wished to examine the utility of a basket-shaped multielectrode mapping catheter (MMC) in the mapping and ablation of ventricular tachycardia. Methods and Results: This study of sustained monomorphic ventricular tachycardia (SMVT) was conducted in two phases in the postinfarction pig model. In the first phase, the utility of the MMC in providing adequate localization of potential ablation site(s) of SMVT by different techniques (presystolic potentials, pace mapping, and concealed entrainment) was assessed in 21 pigs. In the second phase, ablution of induced SMVT was attempted in 10 pigs. Mapping of SMVT was performed after percutaneous introduction of the MMC to the LV. Comprehensive mapping was performed in 90 episodes of SMVT and required 2.0 to 25 seconds. Diastolic potentials were recorded during 86 episodes; good or identical pace maps (≤9 of 12 paced surface ECG leads identical to ventricular tachycardia surface ECG leads) were obtained in 25 of 31 maps, and entrainment was achieved during 28 of 42 SMVTs. In 10 pigs, 10 SMVTs were recorded at least twice and were considered for radiofrequency ablation. An 8-mm tip ablation catheter was advanced to potential ablation sites with a specially designed 'homing' device, requiring a median time of 120 seconds. In these 10 pigs, either identical pace map (≤11 of 12, 6 SMVTs) or concealed entrainment (4 SMVTs) guided the ablation procedure. After ablation, 8 of 10 SMVTs were rendered noninducible, while 2 pigs died during energy application of degeneration of SMVT to ventricular fibrillation. Conclusion: The MMC allows rapid, comprehensive, and reliable endocardial mapping during SMVTs, which facilitates successful ablation in the porcine post-myocardial infarction model.

KW - Ablation

KW - Endocardium

KW - Mapping

KW - Tachycardia

UR - http://www.scopus.com/inward/record.url?scp=0030881564&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030881564&partnerID=8YFLogxK

U2 - 10.1161/01.CIR.96.7.2430

DO - 10.1161/01.CIR.96.7.2430

M3 - Article

VL - 96

SP - 2430

EP - 2437

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 7

ER -