Impact of Micro-, Mini- and Multi-Electrode Mapping on Ventricular Substrate Characterisation

Arrhythmia & Electrophysiology Review, vol. 9, pp. 128–135

Abstract

Accurate substrate characterisation may improve the evolving understanding and treatment of cardiac arrhythmias. During substrate-based ablation techniques, wide practice variations exist with mapping via dedicated multi-electrode catheter or conventional ablation catheters. Recently, newer ablation catheter technology with embedded mapping electrodes have been introduced. This article focuses on the general misconceptions of voltage mapping and more specific differences in unipolar and bipolar signal morphology, field of view, signal-to-noise ratio, mapping capabilities (density and resolution), catheter-specific voltage thresholds and impact of micro-, mini- and multi-electrodes for substrate mapping. Efficiency and cost-effectiveness of different catheter types are discussed. Increasing sampling density with smaller electrodes allows for higher resolution with a greater likelihood to record near-field electrical information. These advances may help to further improve our mechanistic understanding of the correlation between substrate and ventricular tachycardia, as well as macro-reentry arrhythmia in humans.

Authors 3

1. Benjamin Berte corresponding

   Luzerner Kantonsspital

   Affiliation as printed

   Heart Center, Luzerner Kantonsspital, Lucerne, Switzerland

   . Heart Center, Luzerner Kantonsspital, Lucerne, Switzerland;

2. Katja Zeppenfeld Aachen Department of Cardiology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands

   . Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands;

3. Roderick H. Tung

   University of Chicago

   Affiliation as printed

   Center for Arrhythmia Care, Pritzker School of Medicine University of Chicago Medicine, Chicago, IL, US

   . Center for Arrhythmia Care, Pritzker School of Medicine University of Chicago Medicine, Chicago, IL, US