Safety and Efficacy of Novel Multipolar Steerable Mapping Catheter in
Atrial Arrhythmia: A Single Centre Experience
Abstract
Background: There is limited data on the safety and efficacy of
a novel high-definition mapping catheter with 16 equidistant electrodes
(Advisor HD Grid). We describe procedural details for the treatment of
complex atrial arrhythmias and associated outcomes using this novel
catheter design. Methods and Results: The HD Grid was employed
for patients with clinically relevant arrhythmia using the EnSite
Precision™ electroanatomic mapping system. AVRT and typical flutter
cases were excluded. Major procedural complications were defined as
bleeding, stroke or TIA, sepsis, and death from any cause, whereas minor
complications were defined as no changes to the length of hospital stay
or to the expected management of the patient. Recurrence was defined as
sustained tachycardia after 3 months post-procedure. Consecutive
patients attending for the treatment of paroxysmal atrial fibrillation
(66), persistent atrial fibrillation (38), atrial tachycardia (29), and
atypical flutter (18) were included, resulting in a final inclusion of
142 patients and 151 procedures. Eighty-four patients (55.3%) received
general anesthetic and intracardiac echocardiography was used in 23
(15.1%). Long term follow-up was available in 150/151 procedures, mean
185.2±134.3 days; 32 patients (21.3%) documented recurrence. Three
(2.0%) patients experienced complications within 30-days of the
procedure including acute tamponade (1), TIA (1) and stroke (1) and 1
(0.7%) died from complications of septic arthritis 183 days
post-procedure. Conclusion: The novel HD Grid differs
significantly in design and handling compared to the traditional
multielectrode catheters. Our data report procedural outcomes in line
with contemporary clinical expectations with low complication and
recurrence rates.