Multipolar endocardial mapping of the right heart using a basket catheter: acute and chronic animal studies

Pacing Clin Electrophysiol. 1997 Jan;20(1 Pt 1):51-9. doi: 10.1111/j.1540-8159.1997.tb04811.x.

Abstract

The development of catheter-based ablative techniques for primary atrial and ventricular arrhythmias is likely to be assisted by improved techniques for systematic endocardial activation sequence mapping. RA mapping using a multielectrode basket catheter has been shown to be feasible with minimal acute toxicity in a prior study. The objectives of the current study are to investigate: (1) the utility of the basket catheter for mapping RV activation; and (2) the evolution of acute endocardial lesions produced by basket catheter use in both the RA and RV over 4-8 weeks time. A flexible, 5-spoke basket catheter bearing 25 electrode pairs was placed in the RA (n = 9) or the RV (n = 13) in 22 juvenile sheep (22-56 kg). The catheter was deployed for 0.1-4.1 hr (RA) and 0.3-3.9 hr (RV). In 20 of these 22 animals, 32 recordings were made of filtered (30-250 Hz) bipolar electrograms and surface ECG. Electrograms were timed and used to construct activation sequences based on a schematic of catheter geometry. Hearts were examined either acutely (4 RA and 9 RV studies) or 4-8 weeks after the procedure (5 RA and 4 RV studies). One animal undergoing RA placement had an air embolism resulting in cardiac arrest immediately prior to basket placement; all other animals were stable during placement. RA electrograms of sufficient quality to determine activation time were recorded from 82% of pairs in RA maps, and RV electrograms from 89% of pairs in RV maps. Mean activation sequence duration in RV was 16 ms versus 47 ms in RA (P < 0.0001), making construction of RV maps more difficult. Acute postmortem studies of RV placement revealed a silent apical RV puncture in one animal. Superficial abrasion or ecchymosis of RV endocardium and/or tricuspid valve were noted in six animals. Postmortem exams in both RA and RV chronic studies showed healed endocardial lesions, with only superficial scarring. Rapid RV activation mapping using a basket catheter is feasible, but requires precision recording techniques. Endocardial abrasions produced in lambs both by RA and RV placement of the catheter are healed in < 4-8 weeks, with trivial residua. The multielectrode basket catheter may be applicable to the mapping of tachycardias originating in or involving the right ventricle.

MeSH terms

  • Animals
  • Arrhythmias, Cardiac / diagnosis
  • Arrhythmias, Cardiac / surgery
  • Atrial Function, Right
  • Body Surface Potential Mapping / adverse effects
  • Body Surface Potential Mapping / instrumentation*
  • Cardiac Catheterization / adverse effects
  • Cardiac Catheterization / instrumentation*
  • Catheter Ablation / instrumentation
  • Cicatrix / etiology
  • Ecchymosis / etiology
  • Electrocardiography
  • Electrodes* / adverse effects
  • Embolism, Air / etiology
  • Endocardium / injuries
  • Endocardium / physiology*
  • Equipment Design
  • Feasibility Studies
  • Heart Arrest / etiology
  • Sheep
  • Signal Processing, Computer-Assisted
  • Tachycardia, Ventricular / diagnosis
  • Tricuspid Valve / injuries
  • Ventricular Function, Right
  • Wound Healing