Localized Atrial Tachycardia and Dispersion Regions in Atrial Fibrillation: Evidence of Spatial Concordance
| Autor: | Edouard Gitenay, Sabrina Siame, Jérôme Kalifa, Anis Ayari, Nicolas Maillot, Aicha Fofana, Michel Bremondy, Julien Seitz, Antonio Taormina, Florian Baptiste, Clément Bars |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
spatiotemporal dispersion
medicine.medical_specialty medicine.medical_treatment Concordance mechanism 030204 cardiovascular system & hematology ablation Article Lesion 03 medical and health sciences 0302 clinical medicine Internal medicine Dispersion (optics) medicine In patient 030212 general & internal medicine Atrial tachycardia business.industry Atrial fibrillation General Medicine atrial tachycardia medicine.disease Ablation persistent atrial fibrillation Cardiology Medicine medicine.symptom Spatial relationship business |
| Zdroj: | Journal of Clinical Medicine, Vol 10, Iss 3170, p 3170 (2021) Journal of Clinical Medicine Volume 10 Issue 14 |
| ISSN: | 2077-0383 |
| Popis: | Introduction: During atrial fibrillation (AF) ablation, it is generally considered that atrial tachycardia (AT) episodes are a consequence of ablation. Objective: To investigate the spatial relationship between localized AT episodes and dispersion/ablation regions during persistent AF ablation procedures. Methods: We analyzed 72 consecutive patients who presented for an index persistent AF ablation procedure guided by the presence of spatiotemporal dispersion of multipolar electrograms. We characterized spontaneous or post-ablation ATs’ mechanism and location in regard to dispersion regions and ablation lesions. Results: In 72 consecutive patients admitted for persistent AF ablation, 128 ATs occurred in 62 patients (1.9 ± 1.1/patient). Seventeen ATs were recorded before any ablation. In a total of 100 ATs with elucidated mechanism, there were 58 localized sources and 42 macro-reentries. A large number of localized ATs arose from regions exhibiting dispersion during AF (n = 49, 84%). Importantly, these ATs’ locations were generally remote from the closest ablation lesion (n = 42, 72%). Conclusions: In patients undergoing a persistent AF ablation procedure guided by the presence of spatiotemporal dispersion of multipolar electrograms, localized ATs originate within dispersion regions but remotely from the closest ablation lesion. These results suggest that ATs represent a stabilized manifestation of co-existing AF drivers rather than ablation-induced arrhythmias. |
| Databáze: | OpenAIRE |
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