Impact of high-resolution 3D-mapping with micro-electrodes on catheter ablation of Wolff-Parkinson-White syndrome

• Published in: International journal of cardiology. Heart & vasculature 2024-08, Vol.53, p.101435, Article 101435
• Main Authors: Steinfurt, Johannes, Gressler, Alexander, Stuplich, Judith, Jordan, Eike, Jäckel, Markus, Gjermeni, Diona, Eichenlaub, Martin, Bohnen, Marius, Luik, Armin, Jadidi, Amir, Faber, Thomas S., Stiller, Brigitte, Westermann, Dirk, Arentz, Thomas, Lehrmann, Heiko, Fedorov, Denis
• Format: Article
• Language: English
• ISSN: 2352-9067; 2352-9067
• DOI: 10.1016/j.ijcha.2024.101435

It is currently unknown whether high-resolution 3D-mapping and micro-electrodes add meaningful benefits in catheter ablation of Wolff-Parkinson-White (WPW) syndrome and challenging, e.g. para-Hisian accessory pathways (APs). To compare the mapping resolution, acute success and complication rates in patients with WPW syndrome undergoing a first-time catheter ablation using only a contact force-sensing ablation catheter for mapping or a multi-electrode high-resolution mapping catheter. Fifty consecutive 3D-mapping procedures for WPW syndrome using a 3.5-mm ablation catheter (n = 27) or a multi-electrode high-resolution catheter (n = 23) were retrospectively analyzed regarding mapping resolution defined as first 5/10 msec isochronal activation area, number of RF applications to achieve AP block, occurence of AP automaticity during RF delivery, and acute success and complication rates. Catheter ablation was successful in 48/50 patients with a median of 1 (IQR 1–2) RF applications. Compared to ablation catheter mapping, high-resolution mapping showed a significantly smaller isochronal activation area in the first 5/10 msec (1.25 ± 0.29 vs 0.15 ± 0.03 cm2; P