Sequential ultra-high density contact mapping of persistent atrial fibrillation: An efficient technique for rotors identification

Autor: S. Bun, A.M. Wedn, Nadir Saoudi, D.G. Latcu, T. Delassi, B. Enache, A. Amourha
Rok vydání: 2018
Předmět:
Zdroj: Archives of Cardiovascular Diseases Supplements. 10:92
ISSN: 1878-6480
DOI: 10.1016/j.acvdsp.2017.11.246
Popis: Background Whether ultra-high density (UHD) contact mapping (Rhythmia) may be used to map activation of atrial fibrillation (AF) is unknown. Purpose We sequentially mapped the left atrial (LA) activation during AF ablation (circumferential pulmonary vein isolation–CPVI, followed by defragmentation). Methods Time reference was an LA appendage (LAA) electrogram (EGM). Points were acquired with respiratory gating if reference, mapped EGM (10 ms tolerance) and electrode location were stable. For fragmented EGM the timing of the surrounding area was used. In case of extremely low voltage ( Fig. 1 ). Results AF was mapped in 17 patients (patients; 9 men, 68 ± 5 y). LA maps (162 ± 49 ml, 30947 ± 14061 EGM, 95 ± 26 cm2) were acquired in 15.7 ± 6.5 minutes. In 70% of the cases, stable rotating drivers (mean 1.9, 1 to 5) with continuous activation in the centre were visualized. All patients had CPVI followed by ablation of the centre of rotational regions and at sites with fragmented bipolar EGM. After CPVI, LAA CL increased from 171 ± 10 to 199 ± 14 ms (P = 0.02). Termination of AF without electrical cardioversion was obtained in 62%. Conclusion Sequential UHD activation mapping of AF allows visualisation of areas of rotational activation that are always around a fragmented EGM and seem to be an appropriate target for ablation.
Databáze: OpenAIRE
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