Atrial mapping during pulmonary vein pacing: a novel maneuver to detect and close residual conduction gaps in an ablation line
| Autor: | Rafael Peinado, Sergio Madero, Eduardo Castellanos, Mercedes Ortiz, Jesús Almendral, Teresa Barrio-López, Jefferson Salas |
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| Jazyk: | angličtina |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Catheter ablation Pulmonary veins 030204 cardiovascular system & hematology Ablation Residual Sensitivity and Specificity Article Pulmonary vein 03 medical and health sciences 0302 clinical medicine Heart Conduction System Internal medicine Physiology (medical) medicine Humans 030212 general & internal medicine Heart Atria Pace and map business.industry Body Surface Potential Mapping Cardiac Pacing Artificial Electric Conductivity Reproducibility of Results Atrial fibrillation Middle Aged Thermal conduction medicine.disease Treatment Outcome Surgery Computer-Assisted Line (geometry) cardiovascular system Cardiology Catheter Ablation Female Electrical conduction system of the heart business Cardiology and Cardiovascular Medicine |
| Zdroj: | Journal of Interventional Cardiac Electrophysiology |
| ISSN: | 1383-875X |
| DOI: | 10.1007/s10840-016-0159-9 |
| Popis: | Background Location of residual conduction gaps on ablation lines around pulmonary veins (PV) is challenging, and several maneuvers have been described. Atrial mapping during PV pacing—the “pace and map” maneuver—could localize gaps. Methods and results We prospectively studied 209 patients undergoing PV isolation at a single institution over a 25-month period. In 24 (11.4 %) patients, 26 PV remained connected after an ablation line and an initial conventional gap closure protocol. The atrial side of the ablation line was mapped with the ablation catheter during PV pacing, and the earliest site was considered a gap site. Ablation at these gap sites resulted in bidirectional PV conduction block in 22 PV (85 %) in 21 patients (88 %), after 2.2 ± 1.6 radiofrequency applications and 8.2 ± 4.8 min. Early PV reconnection (≥20 min) occurred in 0 PV (0 %). During a mean follow-up of 12 ± 6 months, eight patients (33 %) had arrhythmia recurrences. Conclusions The “pace and map” maneuver is a relatively simple and efficacious means to identify gaps in ablation lines around PV, focusing on the atrial rather than the PV side of the line. It could be considered among the ways to eliminate residual conduction gaps. |
| Databáze: | OpenAIRE |
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