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Value of high-density mapping in the electrophysiology laboratory

Shen, Mark J.; Knight, Bradley P.

Current Opinion in Cardiology: January 2019 - Volume 34 - Issue 1 - p 6–15
doi: 10.1097/HCO.0000000000000576
ARRHYTHMIAS: Edited by Wilber W. Su
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Purpose of review This article uses three commonly encountered clinical scenarios to highlight the value of high-density mapping in the electrophysiology laboratory for the identification of the circuits and substrates during catheter ablation of complex arrhythmias.

Recent findings High-density mapping gathered with a multielectrode catheter, with its smaller individual electrode size and closer interelectrode spacing, helps during ablation procedures in a number of ways. When high-density mapping is performed during tachycardia, the characterization of macro-reentrant circuits is better. When there is suspicion of a change in tachycardia during mapping or ablation, the threshold of remapping is significantly lower because of the speed of remapping. When mapping is done during sinus rhythm (substrate mapping), the identification of true scar is more accurate. Lastly, when extensive ablation of a critical isthmus fails to terminate a tachycardia, high-density mapping may reveal the gap(s) along the ablation line and may provide an alternative approach for ablation.

Summary High-density mapping shows promises of improving procedural outcomes with shorter procedural times.

Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA

Correspondence to Bradley P. Knight, MD, Feinberg School of Medicine, Northwestern University, 251 E. Huron St., Suite 8-503, Chicago, IL 60611, USA. Tel: +1 312 926 5013; fax: +1 312 926 2707; e-mail: bknight@nm.org

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