Abstract
BackgroundThe Advisor™ HD Grid Mapping Catheter (Abbott Technologies, Minneapolis, MN) has been recently introduced. Although the clinical use of HD Grid mapping catheter is well described in adults with no congenital heart disease, there is limited data on the feasibility of using the HD Grid multipolar catheter to create voltage and activation mapping in adults with congenital heart disease. The purpose of this study was to evaluate the safety and technical feasibility of using the Advisor™ HD Grid mapping catheter during the catheter ablation of atrial arrhythmias in adults with congenital heart disease. We included 6 consecutive adults with congenital heart disease suffering from atrial arrhythmias in our study. The HD Grid mapping catheter was used to perform voltage and activation mapping.ResultsSix patients with congenital heart diseases (d-TGA n = 1, Tricuspid atresia n = 1, atrioventricular defect repair n = 1, secundum atrial septal defect n = 1, double-inlet single-ventricle n = 1, Tetralogy of Fallot = 1); majority (84%) male, with the mean age was 35 ± 10 years included in our series. The mean ablation duration and the fluoroscopy time were 789 ± 433 and 502 ± 355 s, respectively. The mean radiation dose was 7.52 ± 9 milliGy/cm2. The HD Grid mapping catheter was used successfully for entire arrhythmia mapping in 5 out of 6 cases. During one procedure, HD Grid mapping catheter could not be used for the entire mapping due to suboptimal reach through baffle puncture. The acute success rate of ablation was 100% with no immediate complications.ConclusionsThe use of HD Grid mapping catheter is a safe and valuable adjunct to accurately create voltage and activation mapping in ACHD patients undergoing radiofrequency catheter ablation. However, a contact force-sensing ablation catheter should be considered in conjunction to supplement data acquisition in challenging anatomy and substrates.
Highlights
The AdvisorTM HD Grid Mapping Catheter (Abbott Technologies, Minneapolis, MN) has been recently introduced
Studies have demonstrated that the use of threedimensional electroanatomic mapping systems to guide atrial arrhythmia ablation in Adults with complex congenital heart disease (ACHD) patients are associated with better clinical outcome [5, 6]
The purpose of our study was to assess the feasibility and safety of using the HD Grid mapping catheter (HGMC) to facilitate the catheter ablation in patients with ACHD. This case series includes six consecutive ACHD patients referred to our centre for EP study and catheter ablation of drug refractory symptomatic AAs
Summary
The AdvisorTM HD Grid Mapping Catheter (Abbott Technologies, Minneapolis, MN) has been recently introduced. The purpose of this study was to evaluate the safety and technical feasibility of using the AdvisorTM HD Grid mapping catheter during the catheter ablation of atrial arrhythmias in adults with congenital heart disease. We included 6 consecutive adults with congenital heart disease suffering from atrial arrhythmias in our study. Adults with complex congenital heart disease (ACHD) may develop symptomatic drug-refractory arrhythmias requiring electrophysiology (EP) studies and catheter ablations. Either the ablation catheter or a circumferential mapping catheter is utilized to create the geometry of the chamber of interest and to perform the activation mapping. Owing to their complex cardiac anatomy, the mapping process is often time-consuming and challenging in ACHD patients. These patients have multiple inducible arrhythmias, so repeated mapping is time-consuming and makes the procedure long
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