A Direction-independent, High-density Mapping Catheter Provides Electrophysiological Advantage in Complex Atrial Tachycardia Ablation Following Pulmonary Vein Isolation.

Catheter ablation of recurrent atrial arrhythmias following pulmonary vein isolation can be challenging given the complex nature of previously ablated tissue, and managing these already complex cases may be rendered more difficult by the impact of wavefront directionality on mapping catheter orientation, which can make the accurate identification of arrhythmogenic substrate more difficult to achieve. In this report, a 72-year-old man with a history of symptomatic paroxysmal atrial fibrillation and prior pulmonary vein isolation (PVI) underwent repeat ablation. Importantly, this case study demonstrates how a direction-independent high-density mapping catheter (Advisor™ HD Grid; Abbott, Chicago, IL, USA) can identify fractionated low-voltage zones that may be missed when using a standard linear ablation catheter.