PentaRay (R) Multielectrode Mapping Catheter for Atrial Tachyarrhythmia in Adults With Congenital Heart Disease

Background: Ablation of atrial tachyarrhythmia in adults with congenital heart disease (ACHD) is challenging because of complex anatomy and high scar burden. We proposed that the addition of high-density mapping with the PentaRay (R) (Biosense Webster, Inc) mapping catheter (EAM+P) to 3-dimensional electroanatomic mapping (EAM) allows for rapid acquisition of high-resolution maps and shorter procedure times. Methods: In this single-center, retrospective cohort study of patients with ACHD who underwent atrial arrhythmia ablation, patients were divided those who underwent ablation with EAM and those who underwent ablation with EAM+P. Results: Fifteen ablations were performed in 13 patients using standard EAM, and 11 ablations were performed in 10 patients using EAM+P. There was no difference in mean age or complexity of congenital heart disease. The procedure duration was 1.5 times longer in the EAM than in the EAM+P group (P =.015). The dose area product was 12 times higher in the EAM than in the EAM+P group (P =.001). A higher number of venous access sites were used for EAM cases than for EAM+P cases (P =.008). Acute success rates of ablation and recurrence rates at 1 year were similar in the 2 groups. There were no procedure-related complications in either group. Conclusion: This is the first study to evaluate the use of the PentaRay (R) high-density mapping catheter for ablation of atrial tachyarrhythmia in patients with ACHD. The use of the PentaRay (R) high-density mapping catheter results in shorter procedure time, decreased radiation exposure, and fewer venous access sites.