Evaluation of a novel high-resolution mapping technology for ablation of recurrent scar-related atrial tachycardias
| Autor: | Hiroshi Nakagawa, Patricia Tung, Jianqing Li, Thomas H. McElderry, Charles I. Haffajee, Eran Leshem, Mark E. Josephson, Fernando M. Contreras-Valdes, Elad Anter |
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| Rok vydání: | 2016 |
| Předmět: |
Tachycardia
Male medicine.medical_specialty Radiofrequency ablation medicine.medical_treatment High resolution 030204 cardiovascular system & hematology law.invention 03 medical and health sciences Cicatrix 0302 clinical medicine law Heart Conduction System Physiology (medical) Internal medicine Outcome Assessment Health Care medicine Tachycardia Supraventricular Humans 030212 general & internal medicine Prospective Studies Atrial tachycardia Intraoperative Care business.industry Atrial fibrillation Middle Aged medicine.disease Ablation Catheter medicine.anatomical_structure Treatment Outcome Dimensional Measurement Accuracy Cardiology Catheter Ablation Female medicine.symptom Cardiology and Cardiovascular Medicine business Electrophysiologic Techniques Cardiac Interatrial septum |
| Zdroj: | Heart rhythm. 13(10) |
| ISSN: | 1556-3871 |
| Popis: | Background Rhythmia is a new technology capable of rapid and high-resolution mapping. However, its potential advantage over existing technologies in mapping complex scar-related atrial tachycardias (ATs) has not yet been evaluated. Objective The purpose of this study was to examine the utility of Rhythmia for mapping scar-related ATs in patients who had failed previous ablation procedure(s). Methods This multicenter study included 20 patients with recurrent ATs within 2 years after a previous ablation procedure (1.8 ± 0.7 per patient). In all cases, the ATs could not be adequately mapped during the index procedure because of scar with fractionated electrograms, precluding accurate time annotation, frequent change in the tachycardia in response to pacing, and/or degeneration into atrial fibrillation. These patients underwent repeat mapping and ablation procedure with Rhythmia. Results From a total of 28 inducible ATs, 24 were successfully mapped. Eighteen ATs (75%) terminated during radiofrequency ablation and 4 (16.6%) with catheter pressure or entrainment from the site of origin or isthmus. Two ATs that were mapped to the interatrial septum slowed but did not terminate with ablation. In 21 of 24 ATs the mechanism was macroreentry, while in 3 of 24 the mechanism was focal. Interestingly, in 5 patients with previously failed ablation of an allegedly "focal" tachycardia, high-resolution mapping demonstrated macroreentrant arrhythmia. The mean mapping time was 28.6 ± 17 minutes, and the mean radiofrequency ablation time to arrhythmia termination was 3.2 ± 2.6 minutes. During a mean follow-up of 7.5 ± 3.1 months, 15 of 20 patients (75%) were free of AT recurrences. Conclusion The Rhythmia mapping system may be advantageous for mapping complex scar-related ATs. |
| Databáze: | OpenAIRE |
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