Catheter Ablation -> Ventricular Arrhythmias -> Mapping & Imaging D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-188 - Miniaturized Octopolar Catheter For Mapping In Cardiac Veins: Early Experience Guiding Ethanol Infusion In The Vein Of Marshall And LV Summit Veins (ID 134)

 A. Da-Wariboko: Nothing relevant to disclose.


Background: Cardiac vein mapping could allow for characterization of arrhythmogenic substrates deep in the septum for LV summit ventricular Arrhythmias (VA) or in the epicardium through the vein of Marshall (VOM), or to verify ablation when venous ethanol is used. There are no currently available small multipolar catheters for small vein mapping.
Objective: To test the octopolar, 2F,EP Star catheter (Baylis, Toronto, CA), mapping either the VOM and septal veins in LV summit VAs.
Results: We report 12 consecutive cases utilizing the aforementioned catheter for coronary venous angiogram-guided mapping, either assessing endo-epi activation patterns in the mitral isthmus via the VOM (n=7) or mapping septal veins for LV summit VAs (n=4) or lateral veins for ischemic VT (n=1). There was successful cannulation of the VOM in seven cases, two of which we demonstrated endo-epicardial dissociation with opposite propagation direction (Figure, top). In LV summit VA, septal vein mapping identified targeted vein for successful ablation via ethanol infusion. (Figure, bottom). Epicardial vein VT maps identified VT substrate in 1 case. Vein cannulation after ethanol infusion showed elimination of local electrograms.
Conclusion: The Octopolar 2F EP star allows mapping and pacing from VOM, LVS and epicardial veins to detect complex activation patterns. It can characterize epicardial signals and verify ethanol induced ablation.