Electroanatomic Mapping to Identify Breakthrough Sites in Recurrent Typical Human Flutter
| Autor: | Birender Boveja, Atul Bhatia, Sharad Rathod, Sanjay Deshpande, Zalmen Blanck, Ryan Cooley, Masood Akhtar, Jasbir Sra, Anwer Dhala |
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| Rok vydání: | 2000 |
| Předmět: |
Male
congenital hereditary and neonatal diseases and abnormalities Electroanatomic mapping medicine.medical_specialty Time Factors medicine.medical_treatment Catheter ablation Amiodarone Inferior vena cava Heart Conduction System Recurrence Internal medicine Typical atrial flutter medicine Humans cardiovascular diseases business.industry General Medicine Middle Aged medicine.disease Ablation Atrial Flutter medicine.vein Catheter Ablation cardiovascular system Cardiology Flutter Female Electrophysiologic Techniques Cardiac Cardiology and Cardiovascular Medicine business Atrial flutter Follow-Up Studies medicine.drug |
| Zdroj: | Pacing and Clinical Electrophysiology. 23:1479-1492 |
| ISSN: | 1540-8159 0147-8389 |
| Popis: | SRA, J., et al.: Electroanatomic Mapping to Identify Breakthrough Sites in Recurrent Typical Human Flutter. The accuracy of conventional techniques in localizing previous radiofrequency (RF) ablation sites and thus breakthrough sites of recurrent atrial flutter is somewhat limited. We investigated the role of electroanatomic mapping for identifying breakthrough sites or “gaps” at the tricuspid annulus and inferior vena cava (IVC)/eustachian ridge isthmus to help RF ablation in patients with recurrent typical flutter. Twelve patients (8 men, 4 women, age 63 ± 10 years) with recurrent typical atrial flutter were included in the study. An electroanatomic mapping system (CARTO) was used to create a voltage map and activation and propagation patterns in the right atrium. Detailed voltage, activation, and propagation mapping of the tricuspid annulus and IVC/eustachian ridge isthmus allowed precise identification of gaps in all 12 patients at the tricuspid annulus (eight sites), IVC ridges (two sites), mid-isthmus region (one site), and tricuspid annulus and IVC ridges (one site). Radiofrequency energy directed at these sites eliminated atrial flutter in all 12 patients, confirmed by noninducibility of atrial flutter and demonstration of conduction block during atrial pacing on either side of the lesion lines. During a mean follow-up of 14.8 ± 3.5 months (range 8–19 months), paroxysmal atrial flutter recurred in only one patient and was subsequently treated with amiodarone, although this had been ineffective prior to ablation. Electroanatomic mapping can precisely identify gaps in the lesion line responsible for breakthrough of recurrent typical atrial flutter at the tricuspid annulus and at the IVC/eustachian ridge isthmus. These sites can be targeted with RF ablation with a high degree of success. |
| Databáze: | OpenAIRE |
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