Comparison of LA and PVC mapping using OCTARAY and OPTRELL catheters

Background Multielectrode mapping catheters, such as the OCTARAY and OPTRELL, are essential in creating myocardial electroanatomical mapping in arrhythmias. The OCTARAY is a multi-spline mapping catheter with 48 closely spaced multielectrodes that enables high-resolution electroanatomical mapping, while the OPTRELL is a multi-electrode catheter with 36 electrodes arranged on eight radiating splines. However, only a few studies have compared their performance. In this study, we aimed to compare the OCTARAY and OPTRELL catheters in two areas: left atrial (LA) mapping during atrial fibrillation (AF) ablation; and premature ventricular contraction (PVC) mapping.

Twenty patients (Ten patients for LA mapping and ten for PVC mapping) were enrolled. LA voltage mapping was performed twice, alternating between catheters post-AF ablation. Parameters compared included mapping time, mapping points, catheter-induced premature atrial contraction (PACs), tissue proximity indication, low voltage area, and fluoroscopy time. For PVC mapping, comparisons included mapping time, catheter-induced PVCs, earliest activation time measured from the onset of PVC QRS, earliest activation point, and fluoroscopy time.

Compared with THE OCTARAY, mean voltage using the OPTRELL was higher (0.192 mV[0.072, 0.48] vs. 0.126 mV[0.042, 0.378]; P = .001) and the percentage of tissue proximity indication positive was also higher (14.97% vs. 11.45%; P < .001). However, there were no significant differences in low voltage area between the two groups (39.5 m2[16.5, 66.8] vs. 40[23.6, 61]; P = .861), and in other LA parameters. In PVC mapping, catheter-induced PVCs using OPTRELL were significantly fewer than the OCTARAY (100 [32, 337] vs. 247 [110, 745], P = .039), with fewer catheter induced PVCs per minute (15 [6, 23] vs. 35 [20, 71], P = .039). However, no significant differences were observed in other PVCs mapping parameters.

The OPTRELL catheter demonstrated higher voltage recordings in LA mapping and fewer catheter-induced PVCs compared with the OCTARAY catheter. However, no significant difference was observed in other mapping parameters. Competing Interest Statement The authors have declared no competing interest. Clinical Trial This study involved human participants and was approved by the Showa University Ethics Committee (ID: 2024-288-B). Funding Statement The authors (s) declare no financial support for the research, authorship, or publication of this article. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: the Showa University Ethics Committee (ID: 2024-288-B) I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data availability statement The original contributions presented in the study are included in the article, and further inquiries can be directed to the corresponding author. Abbreviation - LA - Left Atrium - PVC - Premature Ventricular Contraction - AF - Atrial Fibrillation - EGM - Electrogram - TPI - Tissue Proximity Indication - LVA - Low-Voltage Area - PVI - Pulmonary Vein Isolation - ACT - Activated Clotting Time - AI - Ablation Index - CF - Contact Force