Orthogonal electrode catheter array for mapping of endocardial focal site of ventricular activation

Journal Article · Mon Apr 01 00:00:00 EST 1991 · PACE, Pacing and Clinical Electrophysiology; (United States)

DOI:https://doi.org/10.1111/j.1540-8159.1991.tb02828.x· OSTI ID:5590135

Desai, J M; Nyo, H; Vera, Z; Seibert, J A; Vogelsang, P J ^[1]

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1. Division of Cardiovascular Medicine, University of California, School of Medicine, Davis (USA)

Precise location of the endocardial site of origin of ventricular tachycardia may facilitate surgical and catheter ablation of this arrhythmia. The endocardial catheter mapping technique can locate the site of ventricular tachycardia within 4-8 cm2 of the earliest site recorded by the catheter. This report describes an orthogonal electrode catheter array (OECA) for mapping and radiofrequency ablation (RFA) of endocardial focal site of origin of a plunge electrode paced model of ventricular activation in dogs. The OECA is an 8 F five pole catheter with four peripheral electrodes and one central electrode (total surface area 0.8 cm{sup 2}). In eight mongrel dogs, mapping was performed by arbitrarily dividing the left ventricle (LV) into four segments. Each segment was mapped with OECA to find the earliest segment. Bipolar and unipolar electrograms were obtained. The plunge electrode (not visible on fluoroscopy) site was identified by the earliest wave front arrival times of -30 msec or earlier at two or more electrodes (unipolar electrograms) with reference to the earliest recorded surface ECG (I, AVF, and V1). Validation of the proximity of the five electrodes of the OECA to the plunge electrode was performed by digital radiography and RFA. Pathological examination was performed to document the proximity of the OECA to the plunge electrode and also for the width, depth, and microscopic changes of the ablation. To find the segment with the earliest LV activation a total of 10 {plus minus} 3 (mean {plus minus} SD) positions were mapped. Mean arrival times at the two earlier electrodes were -39 {plus minus} 4 msec and -35 {plus minus} 3 msec. Digital radiography showed the plunge electrode to be within the area covered by all five electrodes in all eight dogs. The plunge electrode was within 1 cm2 area of the region of RFA in all eight dogs.

• OSTI ID: 5590135
• Journal Information: PACE, Pacing and Clinical Electrophysiology; (United States), Vol. 14:4 Pt 1; ISSN 0147-8389
• Country of Publication: United States
• Language: English

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