Fluoroless Mapping and Ablation with Integration of a Pentaspline Pulsed Field Catheter
Bibliographic record
Abstract
Introduction: Fluoroless mapping and ablation using Pentaspline pulsed field ablation catheter has many advantages. This can be achieved using “tripolar configuration” which enables high-quality electroanatomical maps, improved ability to localize EGMs, minimize use of additional mapping catheter when compared to the standard bipole configuration. We aimed to evaluate the benefits of using tripolar configuration in fluoroless atrial fibrillation ablation when compared to the standard bipolar configuration. Methods: The study was approved by the local Institutional Review Board. This study aims to compare a standard method of pinning the pentaspline catheter to an alternative “tripolar pinning” technique. In the tripolar pinning configuration, visualization of not only the 3rd electrode but also the “interpolation of electrode 1, 2, & 4 on each spline is done. Procedures were performed under general anesthesia, EnsiteX system (Abbott, Abbott Park, IL) was used for mapping. Intracardiac echo and electroanatomical map was used to identify catheter location and identify local EGMs. Tripole and standard bipole signals were displayed on the same page to evaluate the signals pre and post each PFA application. Results: Ablation was performed in 59 cases (42 males, average age 65 (30 – 85); 17 females, average age 74 (59 – 83)) in which we configured the catheter in tripole for comparison with the standard bipole setup. Geometry and post voltage maps were created using the tripolar signals in 40 of the 59 patients. Average case duration was 85 minutes (53 – 198; PVI alone 70 minutes (53 – 97)). The average number of PFA applications was 48 (31 – 72). Standard bipole EGMs demonstrated a large far field component when compared to tripole configuration. Ectopic atrial foci, atrial flutters were successfully mapped and ablated in four and five patients respectively. We were able to demonstrate line of block across mitral isthmus and cavotricuspid isthmus ablation. In cases where mapping was performed, geometry creation with the tripoles allowed for field scaling on Ensite X. Conclusion: Integration of the pentaspline pulsed field ablation catheter with the tripolar configuration is feasible and facilitates fluoroless PVI.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".