High-density mapping with fragmentation analysis in patients with reentrant atrial tachycardias (MAP-FLURHY study)
| Autor: | Javier Moreno, Inmaculada Sánchez, Antonio Hernández-Madrid, Cristina Lozano Granero, Eduardo Franco, José Luis Zamorano, Roberto Matía |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment High density 030204 cardiovascular system & hematology Electrocardiography 03 medical and health sciences 0302 clinical medicine Heart Rate Physiology (medical) Internal medicine medicine Humans Sinus rhythm In patient 030212 general & internal medicine Cycle length Atrial tachycardia business.industry Atrial arrhythmias Ablation Catheter Ablation Tachycardia Ventricular Cardiology Focal ablation medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Interventional Cardiac Electrophysiology. 63:513-522 |
| ISSN: | 1572-8595 1383-875X |
| DOI: | 10.1007/s10840-021-01012-z |
| Popis: | Reentrant atrial tachycardias (ATs) use areas of slow conduction that can be visualized as fragmented electrograms. We aimed to test an ablation strategy based on the identification and ablation of spots with fragmented electrograms in reentrant ATs, using Rhythmia navigation system.All consecutive patients from June 2016 to June 2019 were included. The IntellaMap ORION Catheter was used to detect sites with fragmentation, arbitrarily defined as fragmented electrograms 70 ms. Entrainment was used to check if these areas belonged to the AT circuit. Ablation targeted the longest fragmented electrogram within the circuit: focal ablation for microreentries and lines for macroreentries. Ablation success was defined from each AT as conversion to sinus rhythm or another AT.Twenty-seven consecutive patients with 44 mappable ATs were included. All ATs showed sites with fragmented electrograms (104 sites; 2.4 sites per AT); 43/44 ATs had fragmented electrograms within the circuit, which were the target of ablation. Ablation success: 34/36 ATs (94%); success could not be assessed in 8 circuits, in 6 due to mechanical conversion to sinus rhythm at the target fragmented site. Fragmented electrograms within the AT circuits were longer than electrograms outside the circuits (110 ± 30 vs 90 ± 15 ms, p 0.001). A fragmentation duration 100 ms/ 40% of the AT cycle length predicted to be a successful site for ablation with 72.3%/73.8% specificity, respectively. Sixty-two percent of the patients were free from atrial arrhythmias at 1 year.Most ATs had detectable fragmented electrograms within the circuit, which could be the target of ablation with high efficacy. |
| Databáze: | OpenAIRE |
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