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Takase S, Mukai Y, Nagaoka K, Ogawa K, Kawai S, Honda N, Nagayama T, Tohyama T, Inoue S, Sadamatsu K, Tashiro H, Sakamoto K, Matoba T, Chishaki A, Kinugawa S, Tsutsui H. Mapping of Purkinje-related ventricular arrhythmias by a multispline catheter with small and close-paired electrodes: Comparison with conventional catheters. Pacing Clin Electrophysiol 2024; 47:5-18. [PMID: 38112039 DOI: 10.1111/pace.14906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 11/20/2023] [Accepted: 12/05/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Precise mapping of the Purkinje fiber network is essential in catheter ablation of Purkinje-related ventricular arrhythmias (PrVAs). We sought to evaluate the mapping ability of a multi-spline duodecapolar catheter (PentaRay) for PrVAs. METHODS Mappings of Purkinje fibers by PentaRay catheters were compared with those by conventional mapping catheters in consecutive patients undergoing catheter ablation of PrVAs from 2015 to 2022. RESULTS Sixteen PrVAs (7 premature ventricular contractions or non-reentrant fascicular tachycardias [PVCs/NRFTs] and 9 fascicular ventricular tachycardias [FVTs]) were retrospectively studied. In PVCs/NRFTs, earliest preceding Purkinje potentials (PPs) could be recorded by the PentaRay catheters but not by the mapping and ablation catheters in 5 cases. At the earliest PP sites, the precedence from the QRS onset was greater, and the amplitude of the preceding potentials was higher in the PentaRay catheter compared with those in the mapping and ablation catheter (-62.0 ± 42.8 vs. -29.4 ± 34.2 ms, P = 0.02; 0.45 ± 0.43 vs. 0.09 ± 0.08 mV, P = 0.02). In FVTs, late diastolic potentials (P1) were recorded by the PentaRay catheters but not by the mapping and ablation catheters or the linear duodecapolar catheter in 2 cases. The amplitude of P1 was higher in the PentaRay catheter compared with that in the linear duodecapolar catheter and the mapping and ablation catheters (0.72 ± 0.49 vs. 0.17 ± 0.18 vs. 0.27 ± 0.21 mV, P = 0.0006, P = 0.002). The localized critical PPs, defined as the earliest preceding potentials in PVCs/NRFTs and P1 in FVTs, could be recorded in all the patients by the PentaRay catheter. The mapping ability of critical PPs of PrVAs was better with the PentaRay catheter than with the conventional mapping catheters (16/16 vs. 9/16, P = 0.004 by McNemar exact test). CONCLUSIONS The PentaRay catheter has clinical advantages in mapping of the Purkinje fiber network to reveal critical PPs as ablation targets of PrVAs.
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Affiliation(s)
- Susumu Takase
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
- Division of Cardiology, St Mary's Hospital, Kurume, Japan
| | - Yasushi Mukai
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
- Division of Cardiology, Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - Kazuhiro Nagaoka
- Division of Cardiology, St Mary's Hospital, Kurume, Japan
- Division of Cardiology, Fukuoka City Hospital, Fukuoka, Japan
| | - Kiyohiro Ogawa
- Division of Cardiology, Fukuoka City Hospital, Fukuoka, Japan
| | - Shunsuke Kawai
- Division of Cardiology, Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - Nobuhiro Honda
- Division of Cardiology, St Mary's Hospital, Kurume, Japan
| | - Tomomi Nagayama
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeshi Tohyama
- Center for Clinical and Translational Research, Kyushu University, Fukuoka, Japan
| | - Shujiro Inoue
- Division of Cardiology, Iizuka Hospital, Iizuka, Japan
| | | | - Hideki Tashiro
- Division of Cardiology, St Mary's Hospital, Kurume, Japan
| | - Kazuo Sakamoto
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tetsuya Matoba
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akiko Chishaki
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
- School of Medicine and Graduate School, International University of Health and Welfare, Okawa, Japan
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Scaglione M, Cerrato N, Spinoni EG, Battaglia A, Geuna F, Caponi D. Electroanatomic visualization of reentrant circuit of left fascicular ventricular tachycardia guiding a fluoroless ablation. HeartRhythm Case Rep 2023; 9:745-748. [PMID: 38047191 PMCID: PMC10691950 DOI: 10.1016/j.hrcr.2023.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Affiliation(s)
- Marco Scaglione
- Division of Cardiology, Cardinal Massaia Hospital, Asti, Italy
| | | | | | | | - Francesco Geuna
- Division of Cardiology, Cardinal Massaia Hospital, Asti, Italy
| | - Domenico Caponi
- Division of Cardiology, Cardinal Massaia Hospital, Asti, Italy
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Naeemah QJ, Nogami A, Komatsu Y, Oda Y, Phanthawimol W, Yamasaki H, Igarashi M, Aonuma K, Ieda M. Effect of Interelectrode Spacing on Measurements of Purkinje Potential During Fascicular Ventricular Tachycardia. JACC Clin Electrophysiol 2022; 8:530-532. [PMID: 35450610 DOI: 10.1016/j.jacep.2022.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/28/2021] [Accepted: 01/01/2022] [Indexed: 11/16/2022]
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Toba M, Nasu T, Nekomiya N, Itasaka R, Makino T, Yokoshiki H. A single premature stimulation from the para-Hisian region unmasked negative involvement of the left anterior fascicle in the verapamil-sensitive ventricular tachycardia with a right bundle branch block and right-axis deviation. J Electrocardiol 2021; 68:72-76. [PMID: 34388392 DOI: 10.1016/j.jelectrocard.2021.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Abstract
A 33-year-old man had verapamil-sensitive ventricular tachycardia (VT) with a right bundle branch block (RBBB) and right axis deviation. Programmed stimulation from the para-Hisian region induced ventricular tachycardias (VT1 or VT2). VT1 was entrained during pacing from the para-Hisian region. A single para-Hisian stimulation antidromically captured the proximal portion of the left anterior fascicle (LAF), but the cycle length of VT2 remained unchanged. This observation indicated that the upper limb of the LAF was a bystander of the reentry circuit. We have clarified this mechanism with applying a single premature stimulation from the para-Hisian region.
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Affiliation(s)
- Masahiro Toba
- Department of Cardiovascular Medicine, Sapporo City General Hospital, Sapporo, Japan.
| | - Toshihiro Nasu
- Division of Medical Engineering Center, Sapporo City General Hospital, Sapporo, Japan
| | - Nobuyoshi Nekomiya
- Division of Medical Engineering Center, Sapporo City General Hospital, Sapporo, Japan
| | - Ryo Itasaka
- Division of Medical Engineering Center, Sapporo City General Hospital, Sapporo, Japan
| | - Takao Makino
- Department of Cardiovascular Medicine, Sapporo City General Hospital, Sapporo, Japan
| | - Hisashi Yokoshiki
- Department of Cardiovascular Medicine, Sapporo City General Hospital, Sapporo, Japan.
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