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(Circulation. 1999;99:2414-2422.)
© 1999 American Heart Association, Inc.

Clinical Investigation and Reports

Clinical Experience With a Novel Multielectrode Basket Catheter in Right Atrial Tachycardias

Presented in part at the 70th Scientific Sessions of the American Heart Association, Orlando, Fla, November 9–12, 1997, and published in abstract form (Circulation. 1997;96[suppl I]:I-586).

Claus Schmitt, MD; Bernhard Zrenner, MD; Michael Schneider, MD; Martin Karch, MD; Gjin Ndrepepa, MD; Isabel Deisenhofer, MD; Sonja Weyerbrock, MD; Jürgen Schreieck, MD; Albert Schömig, MD

From Deutsches Herzzentrum München and 1 Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.

Correspondence to Claus Schmitt, MD, Deutsches Herzzentrum München, Lazarettstrasse 36, D-80636 München, Germany. E-mail schmitt{at}dhm.mhn.de

Background—The complexity of atrial tachycardias (ATs) makes the electroanatomic characterization of the arrhythmogenic substrate difficult with conventional mapping techniques. The aim of our study was to evaluate possible advantages of a novel multielectrode basket catheter (MBC) in patients with AT.

Methods and Results—In 31 patients with AT, an MBC composed of 64 electrodes was deployed in the right atrium (RA). The possibility of deployment, spatial relations between MBC and RA, MBC recording and pacing capabilities, mapping performance, and MBC-guided ablation were assessed. MBC deployment was possible in all 31 patients. The MBC was left in the RA for 175±44 minutes. Stable bipolar electrograms were recorded in 88±4% of electrodes. Pacing from bipoles was possible in 64±5% of electrode pairs. The earliest activity intervals, in relation to P-wave onset, measured from the MBC and standard roving catheters were 41±9 and 46±6 ms, respectively (P=0.21). Radiofrequency ablation was successful in 15 (94%) of 16 patients in whom it was attempted, including 2 patients with polymorphic right atrial tachycardia (RAT), 2 with RAT–atrial flutter combination, 1 with macroreentrant AT, and 1 with focal origin of atrial fibrillation.

Conclusions—These data demonstrate that MBC can be used safely in patients with right atrial arrhythmias. The simultaneous multielectrode mapping aids in the rapid identification of sites of origin of the AT and facilitates radiofrequency ablation procedures. The technique is especially effective for complex atrial arrhythmias.

Key Words: tachycardia • catheters • mapping • catheter ablation

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