Overdrive pacing mapping: An alternative approach used in scar associated localized atrial tachycardia

Autor: Chong Feng, Jeffrey E Kerlan, Paul H Hess, Jingzhou Jiang, Jiangui He, Chen Liu, Yuedong Ma, David Z Lan, Yang Yang, Lichun Wang, Anli Tang
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Electroanatomic mapping
Time Factors
Radiofrequency ablation
medicine.medical_treatment
Action Potentials
Catheter ablation
030204 cardiovascular system & hematology
law.invention
03 medical and health sciences
0302 clinical medicine
law
Heart Rate
Predictive Value of Tests
Physiology (medical)
Internal medicine
Tachycardia
Supraventricular
Medicine
Humans
030212 general & internal medicine
Heart Atria
Atrial tachycardia
Aged
Aged
80 and over
business.industry
Cardiac Pacing
Artificial
Atrial fibrillation
Reentry
Atrial Remodeling
Middle Aged
Ablation
medicine.disease
Cardiac surgery
Treatment Outcome
Cardiology
Catheter Ablation
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Electrophysiologic Techniques
Cardiac
Preliminary Data
Zdroj: Journal of cardiovascular electrophysiology. 30(12)
ISSN: 1540-8167
Popis: Background Mapping and ablation of localized reentry atrial tachycardia (AT) can be challenging, especially in those with varying cycle length (CL). Objective We attempted to use the traditional maneuver of overdrive pacing to facilitate AT mapping. Methods Data were collected from 12 patients with localized ATs. All patients had prior cardiac surgery or prior atrial fibrillation ablation. Overdrive pacing mapping (ODPM) was performed to find independent local activity (ILA) and compared with conventional activation mapping (CAM) during ongoing AT to determine its accuracy and efficacy. Patients with macro-reentry AT around the tricuspid or mitral annulus were excluded. Results Twelve patients with 14 localized ATs were included. All 14 ATs including 4 (29%) with varying CL successfully completed ODPM and had the ILA, although two ATs terminated during ODP and required repeated mapping. Radiofrequency ablation focused on critical sites with ILA was successful in all 12 patients. Using CAM, however, 6 of 14 ATs (43%) mapping attempts were aborted due to AT termination (2 ATs) or varying CL (4 ATs), and only 5 of 8 (63%) located "critical sites" were ultimately confirmed by entrainment and ablation results. After 25 ± 9 months of follow-up, no patient had AT recurrence. Conclusion Our preliminary results demonstrated that ODPM is superior to CAM in ATs that were poorly sustained or with varying CL and is a useful supplement to CAM.
Databáze: OpenAIRE
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