Visualization of residual gaps after linear ablation using the LUMIPOINT TM module: A case report.

Autor:	Egami Y; Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan. Electronic address: egmyasuyuki@gmail.com., Matsunaga-Lee Y; Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan. Electronic address: sumomo0304@gmail.com., Yano M; Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan. Electronic address: myano0820@gmail.com., Nishino M; Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan. Electronic address: 3522mn@gmail.com.
Jazyk:	angličtina
Zdroj:	Indian pacing and electrophysiology journal [Indian Pacing Electrophysiol J] 2024 Nov-Dec; Vol. 24 (6), pp. 361-365. Date of Electronic Publication: 2024 Sep 18.
DOI:	10.1016/j.ipej.2024.09.006
Abstrakt:	Background: Macroreentrant atrial tachycardia (ATs) through epicardial conduction is depicted as a focal AT on 3-D mapping, i.e., pseudo-focal AT. A new feature of the Rhythmia mapping system (Boston Scientific), the "LUMIPOINT module", can highlight all electrocardiograms (EGMs) above a threshold determined by an adjustable confidence slider (CS). Lowering the CS (L-CS) may highlight undetected electrograms (EGMs) at the nominal CS setting, potentially enabling visualization of the critical isthmus of pseudo-focal ATs. Methods and Results: This study included 3 ATs after linear ablation of two left atrial roof-dependent ATs (cases 1 and 2) and one peri-mitral flutter (case 3). All ATs were diagnosed as pseudo-focal AT according to an electrophysiological study and the Rhythmia mapping system with the LUMIPOINT module. The L-CS method consisted of the following steps: 1. Set the LUMIPOINT activation window to the time difference before and after the linear ablation line. 2. Highlight the two regions before and after the linear ablation line. 3. Gradually lower the CS value from the nominal setting of 85 % by 5-10 %. By the L-CS method in cases 1-3, the 2-sided highlighted areas before and after the prior linear ablation lesion gradually expanded and eventually fused. EGMs at the fusion sites of the highlighted areas exhibited fragmented EGMs with a low voltage, where a single-shot ablation terminated the targeted ATs. Conclusion: The L-CS method was useful for the visualization of residual gaps and identification of targeted ablation sites in cases of pseudo-focal AT after linear ablation of macroreentrant ATs. Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024 Indian Heart Rhythm Society. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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