Echocardiographic imaging of a basket catheter for mapping and ablation of ventricular tachycardia in pigs

Our objective was to assess the feasibility and efficacy of the recently described left ventricular simultaneous deployment of a new multi-electrode mapping catheter and a standard radio-frequency ablation catheter in pigs, with echocardiography monitoring and fluoroscopy guidance. Introduction and deployment of both catheters in five healthy anesthetized pigs were guided on-line by fluoroscopy and monitored with transthoracic echocardiography. Heart rate and femoral blood pressure were also continuously monitored. Both catheters were deployed for up to 5 hours. Three animals underwent three to five radio-frequency energy applications. Left ventricular dimensions obtained from long axis two-dimensional echocardiography imaging before and after basket-catheter deployment in the left ventricular cavity, were 3.9 ± 0.3 versus 3.7 ± 0.6 cm at end-diastole and 2.8 ± 1.1 versus 2.6 ± 0.8 cm at end-systole, respectively (mean ± standard error of the mean, p > 0.05). Shortening fraction measured from long axis two-dimensional echocardiography images before and after catheter deployment was 28% ± 10% versus 25% ± 5%, respectively (mean ± standard error of the mean, p > 0.05). Additional findings included the following: (1) good conformation of the multi-electrode mapping catheter to the left ventricular dimensions during diastole; (2) absence of catheter-induced aortic and/or mitral insufficiency, as well as left ventricular outflow tract obstruction; (3) absence of damage to mitral and aortic valves or to the left ventricular wall. Postmortem examination and hemodynamic measurements confirmed these findings and showed only minor subendocardial hemorrhages; (4) radio-frequency energy application produced intracavitary bubbles, which were demonstrable echocardiographically, enabling identification of the gross anatomic location of ablation sites. Echocardiography during simultaneous deployment of multi-electrode mapping catheter and radio-frequency ablation catheters enables estimation of mechanical interaction with the left ventricle and detects interaction with myocardial/valvular function. During radio-frequency energy application, bubble production may identify gross an-atomic location of ablation.