First epicardial mapping of the left ventricle using the Advisor ™ HD Grid catheter

Excerpt

We report, to our knowledge, the first epicardial mapping of ventricular tachycardia (VT) originating from the left ventricle (LV) using the Advisor™ HD Grid mapping catheter (Fa. Abbott, St. Paul, MN, USA). A 60-year-old male patient presented with recurrence of electrical storm in the setting of dilative cardiomyopathy. Interrogation of the pre-existing implantable biventricular cardioverter defibrillator (Viva Quad XT CRT-D, Fa. Medtronic, USA) revealed numerous symptomatic VTs with cycle length of 560 and 580 ms. Because of previous partially successful endo- and epicardial ablation, a primarily endo- and epicardial access was obtained using a retrograde aortic and subxiphoidial epicardial access. For mapping of potential slow conduction areas and LAVAs (local abnormal ventricular activities), a novel high-resolution multipolar catheter (Advisor™ HD Grid mapping catheter (Fa. Abbott, St. Paul, MN, USA)) in conjunction with a 3D mapping system (EnsiteVelocity™, Fa. Abbott, St. Paul, MN, USA) was used. After endo- and epicardial ablation, no recurrence of sustained VT episodes during the procedure and after 3-month follow-up occurred. Epicardial mapping with the Advisor™ HD Grid catheter was safe and feasible in this LV VT ablation procedure. …