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Pentaray nav catheter

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The PentaRay NAV catheter is a medical device designed for cardiac electrophysiology procedures. It features a multi-electrode array that can be used for mapping and recording cardiac electrical activity.

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Lab products found in correlation

Carto 3 system, by Johnson & Johnson (2 mentions) Carto 3, by Johnson & Johnson (2 mentions) Thermocool smarttouch, by Johnson & Johnson (2 mentions) Firmap, by Abbott (2 mentions) Sl1 type swartz sheaths, by Abbott (1 mentions) Thermocool smarttouch catheter, by Johnson & Johnson (1 mentions) Decapolar catheter, by Johnson & Johnson (1 mentions) Cardiolab system, by GE Healthcare (1 mentions)

8 protocols using pentaray nav catheter

1

Electrophysiology Study for Catheter Ablation

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The electrophysiology study was performed after discontinuing antiarrhythmic medications for five half-lives or more than 60 days for amiodarone. Catheters were advanced from the femoral veins to the right atrium (RA), coronary sinus (CS), and transeptally to the left atrium (LA). A decapolar mapping catheter (Biosense Webster, Inc., Diamond Bar, CA, USA) was positioned in the CS via the left femoral vein. Two SL1-type Swartz sheaths (St. Jude Medical, St. Paul, MN, USA) were advanced into the LA after two successful transseptal punctures. After transseptal catheterization, systemic anticoagulation was achieved with intravenous heparin (100 IU/kg) to maintain an activated clotting time between 300 and 350 s. Selective PV venography was performed to identify all PV ostia before ablation. PentaRay NAV catheter (Biosense Webster, Inc., Diamond Bar, CA, USA) was used as a navigational mapping catheter.
Shi W.R., Wu S.H., Zou G.C., Xu K., Jiang W.F., Zhang Y., Qin M, & Liu X. (2022). A novel approach for quantitative electrogram analysis for driver identification: Implications for ablation in persistent atrial fibrillation. Frontiers in Cardiovascular Medicine, 9, 1049854.
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2

Detailed Bipolar Voltage Mapping of Left Atrium

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All cases were performed with CARTO (Biosense Webster Inc., Diamond Bar, CA). LA geometries and detailed bipolar voltage maps were created using a 2‐6‐2 mm spacing PentaRay NAV catheter (Biosense Webster, Inc) with a color fill threshold of 5 mm aiming for complete LA coverage. Low‐voltage zones (LVZs) were defined as sites with a bipolar voltage less than 0.5 mV.5
Honarbakhsh S., Schilling R.J., Providencia R., Keating E., Sporton  S., Lowe M., Lambiase P.D., Chow A., Earley M.J, & Hunter R.J. (2018). Automated detection of repetitive focal activations in persistent atrial fibrillation: Validation of a novel detection algorithm and application through panoramic and sequential mapping. Journal of Cardiovascular Electrophysiology, 30(1), 58-66.
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3

Circumferential Pulmonary Vein Isolation for Atrial Fibrillation

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All patients had undergone circumferential pulmonary vein isolation (CPVI) using
the CARTO® 3 System (Biosense Webster, Irvine, CA, USA; Figure 1c). Under local anaesthesia,
double transseptal punctures were created using a Brockenbrough needle, and two
SL1 sheaths were introduced into the LA via the septum. A 100 U/kg dose of
heparin was administered intravenously, with a target activated clotting-time
value of 300–400 s. The catheters were placed in the LA through SL1 sheaths, and
electroanatomical mapping was performed with a Pentaray NAV catheter (Biosense
Webster). Ablation was performed using a THERMOCOOL SMARTTOUCH® catheter
(Biosense Webster). The endpoint of the CPVI procedure was the achievement of a
complete entrance and exit block. Following confirmation of PVI, a 20-min
waiting period from the last radiofrequency application was required, with
adenosine challenge to rule out dormant reduction.
Chen Z.S., Tan H.W., Song H.M., Xu W.J, & Liu X.B. (2021). Impact of corrected sinus node recovery time in predicting recurrence in patients with paroxysmal atrial fibrillation. The Journal of International Medical Research, 49(5), 03000605211010103.
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4

Left Atrial Voltage Mapping in Persistent AF

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A 20-pole multielectrode catheter (PentaRay Nav Catheter; Biosense Webster, USA) and an irrigated RF catheter (Thermocool® SmartTouch®; Biosense Webster, USA) was used to perform LA voltage mapping in the PsAF group and the SR group, respectively. Low-voltage zones (LVZs) under AF were defined as bipolar voltage < 0.5 mV28 (link)–30 (link), while LVZs under sinus rhythm were considered as the sites displaying < 1.0 mV peak-to-peak bipolar voltage30 (link),31 (link). The LA body area minus the LA appendage, the pulmonary vein antrum regions, and the mitral valve were referred to as the LA surface area. The mean proportion of LVZs on the LA surface area is known as the low voltage area (LVA). Additionally, the atrial surface area and LVA were quantified by using standardized software (CARTO 3, Biosense Webster, USA). Patients with PsAF were divided into LVZs subgroup (n = 12) and non-LVZs subgroup (n = 8) according to the presence or absence of left atrial LVZs.
Liu X., Wu M., He Y., Gui C., Wen W., Jiang Z, & Zhong G. (2023). Construction and integrated analysis of the ceRNA network hsa_circ_0000672/miR-516a-5p/TRAF6 and its potential function in atrial fibrillation. Scientific Reports, 13, 7701.
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5

Catheter Ablation of Infarct-Related VT

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Catheter ablation of infarct-related VT was performed using standard techniques.7 (link) VT was induced by programmed ventricular stimulation from the right ventricular (RV) apex or outflow tract. Access to the LV was achieved via a retrograde aortic or trans-septal approach. For each procedure, Carto 3 (Biosense Webster, Diamond Bar, CA) system was used for electroanatomic mapping (EAM); an EAM was created using an open-irrigated catheter (ThermoCool SmartTouch, Biosense Webster, Diamond Bar, CA) or a multi-electrode catheter (PentaRay NAV Catheter, Biosense Webster). Substrate-based mapping and pace-mapping were used to identify scar and potential culprit sites within the scar, which were targeted for ablation. Radiofrequency (RF) ablation was performed using an open-irrigated catheter (ThermoCool Smart-Touch., Biosense Webster, Diamond Bar, CA) when targeting the critical isthmus and areas of late potentials.
Zhou S., Sung E., Prakosa A., Aronis K.N., Chrispin J., Tandri H., AbdelWahab A., Horáček B.M., Sapp J.L, & Trayanova N.A. (2021). Feasibility study shows concordance between image-based virtual-heart ablation targets and predicted ECG-based arrhythmia exit-sites. Pacing and clinical electrophysiology : PACE, 44(3), 432-441.
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6

Comprehensive Cardiac Mapping Techniques

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Mapping was performed using the CARTOFINDER system (see Supplemental Methods).7
LA geometry and high-density bipolar voltage map were created using a PentaRay NAV catheter with 2-6-2 mm electrode spacing (Biosense Webster) (see Supplemental Methods). Voltage zones were defined as non-LVZ (≥0.5 mV), LVZ (0.2–0.5 mV), and very LVZ (vLVZ) (0–0.2 mV).8 (link) Unipolar electrograms were obtained using a LabSystem Pro electrophysiological recording system (Bard Electrophysiology Division, Natick, MA) by referencing to a decapolar catheter (Biosense Webster) positioned in the inferior vena cava. Filter bandwidth was 0.05–500 Hz.
A 64-pole basket catheter (Constellation, Boston Scientific Ltd, Natick, MA; or FIRMap, Abbott, Santa Clara, CA) was used to record unipolar signals. It was positioned in the LA to achieve the best possible atrial coverage.9 (link)
Honarbakhsh S., Schilling R.J., Orini M., Providencia R., Keating E., Finlay M., Sporton S., Chow A., Earley M.J., Lambiase P.D, & Hunter R.J. (2019). Structural remodeling and conduction velocity dynamics in the human left atrium: Relationship with reentrant mechanisms sustaining atrial fibrillation. Heart Rhythm, 16(1), 18-25.
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7

Scar-related VT Ablation Techniques

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Scar-related VT ablation procedures were performed using standard ablation techniques2 (link), or infusion-needle catheter ablation25 (link). Use of the needle catheter was conducted through the Special Access Program, Health Canada. VT was induced by programmed ventricular stimulation from the right ventricular (RV) apex or outflow tract and the LV was mapped via the retrograde aortic or trans-septal atrial approach. Intracardiac electrograms were digitized and stored by CardioLab system (GE Healthcare, Barrington, Illinois), and three-dimensional (3D) electroanatomic (EA) maps were acquired by the Carto 3 system (Biosense Webster, Irvine, California). Substrate-based mapping and pace-mapping were used to identify scar and potential culprit sites within the scar, which were targeted for ablation. For each procedure, a complete LV endocardial EA map was created using a 3.5-mm tip irrigated catheter (Navistar SmartTouch, Biosense Webster, Diamond Bar, CA, USA) or a high-density multi-electrode catheter (PentaRay NAV Catheter, Biosense Webster). Pacing was performed with stable catheter position at multiple endocardial sites at minimum pacing output that ensured consistent focal myocardial capture.
Zhou S., AbdelWahab A., Horáček B.M., MacInnis P.J., Warren J.W., Davis J.S., Elsokkari I., Lee D.C., MacIntyre C.J., Parkash R., Gray C.J., Gardner M.J., Marcoux C., Choudhury R., Trayanova N.A, & Sapp J.L. (2020). Prospective Assessment of An Automated Intraprocedural 12-lead ECG-Based System for Localization of Early Left Ventricular Activation. Circulation. Arrhythmia and electrophysiology, 13(7), e008262.
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8

High-Density Bipolar Voltage Mapping of Left Atrium

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Mapping was performed with the CARTOFINDER mapping system (CARTO, Biosense Webster, Inc, CA) (11-13, Supplemental Method).
LA geometry and a high-density bipolar voltage map were created in sinus rhythm using a PentaRay® NAV catheter with 2-6-2mm electrode spacing (Biosense Webster, Inc, CA) (Supplemental Method). Non-LVZs were defined as sites with a bipolar voltage of [≥0.5mV], LVZ was defined as [0.2-0.5mV], and very LVZ (vLVZ) was defined as [<0.2mV] (14-16). Bipolar voltages obtained at the pulmonary veins (PVs), mitral valve annulus and LA appendage (LAA) were excluded to allow for a mean bipolar voltage of the LA body only.
A 64-pole basket catheter (Constellation, Boston Scientific Ltd, Natick, MA or FIRMap, Abbott, CA, USA) was used to record unipolar signals and was positioned to achieve optimal coverage (17) (Supplemental Method).
Honarbakhsh S., Schilling R.J., Orini M., Providencia R., Finlay M., Keating E., Lambiase P.D., Chow A., Earley M.J., Sporton S, & Hunter R.J. (2019). Left atrial scarring and conduction velocity dynamics: Rate dependent conduction slowing predicts sites of localized reentrant atrial tachycardias. International journal of cardiology, 278.
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