Impact of Box Isolation on Rotors and Multiple Wavelets in Persistent Atrial Fibrillation
| Autor: | Takashi Ashihara, Koichiro Kumagai, Hideko Toyama |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Anterior wall Action Potentials Catheter ablation 030204 cardiovascular system & hematology Pulmonary vein 03 medical and health sciences 0302 clinical medicine Left atrial Heart Rate Internal medicine Atrial Fibrillation Medicine Humans 030212 general & internal medicine Phase mapping Aged business.industry Atrial fibrillation General Medicine Middle Aged medicine.disease Treatment Outcome Pulmonary Veins Persistent atrial fibrillation Cardiology Catheter Ablation Female Cardiology and Cardiovascular Medicine business Lateral wall Electrophysiologic Techniques Cardiac |
| Zdroj: | Circulation journal : official journal of the Japanese Circulation Society. 84(3) |
| ISSN: | 1347-4820 |
| Popis: | Background Additional benefits of posterior left atrial (LA) box isolation (BOXI) over pulmonary vein isolation (PVI) in persistent atrial fibrillation (perAF) have been reported, but the mechanism is still unclear. We evaluated the effects of BOXI on rotors and multiple wavelets in the whole LA.Methods and Results:Twenty patients with perAF (including 12 cases of longstanding perAF) underwent PVI. Real-time phase mapping (ExTRa Mapping) was performed in the whole LA during AF. Subsequently, BOXI was added and re-ExTRa Mapping was performed again at the same site. The nonpassively activated ratio (%NP), the ratio of the form of rotors and multiple wavelets to the recording time, was compared before and after BOXI. After BOXI, the %NP significantly decreased in the anterior wall (from 53±22% to 39±23%, P=0.010), inferior wall (from 51±16% to 34±19%, P=0.001), and LA appendage (from 23±27% to 16±19%, P=0.049). However, there were no significant differences in the septum (49±19% vs. 49±18%, P=0.562) or lateral wall (41±19% vs. 38±15%, P=0.526). Conclusions BOXI not only reduced the critical mass for maintenance of AF, but also decreased the rotors and multiple wavelets in the anterior wall, inferior wall and LA appendage during perAF. |
| Databáze: | OpenAIRE |
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