203 Catheter Ablation for Focal Atrial and Ventricular Tachycardia Using the High Density Grid Mapping Catheter

The AdvisorTM high density grid (HDG) catheter is a novel 16 electrode mapping catheter which allows for bipole recordings parallel and perpendicular to its splines. This facilitates high density mapping with minimal catheter induced ectopy for focal atrial (AT) and ventricular tachycardia (VT). To describe and compare the clinical and procedural features from a consecutive patient cohort who underwent catheter ablation (CA) for focal AT and VT using the HDG catheter with an age and case matched cohort using conventional point by point (PBP) mapping. Consecutive patients undergoing CA for AT and VT between 2018 -2019 using the HDG were compared with a case control cohort using PBP mapping over a similar time period. 46 patients (23 in HDG vs 23 in conventional mapping) underwent CA, with focal AT (5 RA, 5 LA) and VT (8 RVOT, 4 LVOT, 1 multi-focal) in each group. There was no significant difference between cohorts in baseline characteristics. The HDG group had significantly earlier electrograms (37+/-16 ms vs 32+/-10 ms; p=0.02), shorter procedural duration (132 mins vs 157 mins, p=0.05), more electroanatomic mapping (EAM) points collected (1908 vs 133, p<0.01), & less proportion of points utilised (35% vs 81%, p<0.01). There was no significant difference in fluoroscopy times, procedural success, and arrhythmia recurrence. Multipolar mapping with the HDG catheter for focal tachycardias identified earlier activation times and was associated with shorter procedure duration with equivalent success to PBP mapping.