The use of high-density electroanatomic mapping catheter (Advisor™ HD Grid) in detecting critical Purkinje potentials (P1-P2) in patients with left posterior fascicular VT
Journal of Interventional Cardiac Electrophysiology, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s10840-026-02420-9
- Dergi Adı: Journal of Interventional Cardiac Electrophysiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Anahtar Kelimeler: Fascicular ventricular tachycardia, HD Grid Mapping Catheter
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: In patients with left posterior fascicular ventricular tachycardia (LPF-VT), the most critical determinant of successful radiofrequency ablation (RFA) is the accurate identification of the antegrade and retrograde pathways (P1–P2) within the reentrant circuit. The aim of this study was to evaluate the impact of HD Grid–guided RFA on P1 potential detection, procedural duration, acute procedural success, and arrhythmic recurrence in patients with LPF-VT. Methods: In this retrospective-cohort study, 25-patients with inducible tachycardia during electrophysiological study and a confirmed diagnosis of LPF-VT were included. Patients were divided into two-groups according to the use of the HD Grid Mapping Catheter during RFA: standard RFA group (Group-I) and standard RFA + HD Grid group (Group-II). Patients were followed for a mean duration of 24.8 ± 14.8 months after RFA. Results: In Group-II, the frequency of P1 recording during VT and, consequently, P1-targeted RF applications was significantly higher than in Group-I (92% vs 39%, and, p = 0.008). Acute procedural success was achieved in all 12-patients (100%) in Group-II and in 9-patients (69%) in Group-I (p < 0.047). During follow-up, LPF-VT recurrence occurred in 7-patients (54%) in Group-I and 1-patient (8%) in Group-II (p < 0.020). Conclusion: In this study, the use of the HD Grid Mapping Catheter during RFA for LPF-VT was associated with a higher detection rate of P1 potentials compared with the standard RFA approach. Given the critical role of P1 potentials in determining procedural success, this finding may suggest a potential relationship with shorter procedural and fluoroscopy times, higher acute procedural success rates, and lower LPF-VT recurrence rates in this patient population.