From High-Density Mapping to Low-Density Mapping Outlining the Active Circuit in Complex Atrial Re-Entrant Tachycardias
Por:
Font, ER, Alonso-Martin, C, Guerra, JM, Garcia, BC, Zurita, FM, Rodriguez, OA, Weidmann, ZM, Viamonte, HE, Rami, AE, Chavez, JM, Matos, CG, Montoya, PT, Prat, XV
Publicada:
1 may 2020
Resumen:
OBJECTIVES The aim of this study was to describe a mapping approach for ablation of complex atrial re-entrant tachycardias (ARTS) in which high-density activation maps are transformed into low-density activation maps displaying only the active part of the tachycardia circuit.
BACKGROUND High-density activation maps during complex ARTs are challenging to interpret because they include the activation patterns of active and passive circuits. Entrainment mapping provides the identification of the active tachycardia circuit. However, current etectroanatomic mapping systems are not capable of color-coding the information obtained from entrainment maneuvers.
METHODS Seventeen consecutive patients with atypical atrial flutter were included. A high-density activation map was acquired during index tachycardia. Subsequently, entrainment maneuvers were performed to generate a low-density activation map in which only the activation of the atria directly involved in the flutter circuit was displayed.
RESULTS Of all patients included, 82% were men, and their mean age was 62 +/- 7 years. Structural heart disease was present in 59%, and 53% had undergone prior left atrial ablation procedures. Low-density activation maps were successfully generated from an average of 14 3 entrainment points. Twenty circuits (95%) were identified in the left atrium and 1 (5%) in the right atrium. Ablation guided by tow-density mapping successfully terminated all ARTs in 267 +/- 353 s of radiofrequency application.
CONCLUSIONS Low-density mapping based on entrainment maneuvers provides a precise delineation of the active circuit during complex ARTs and resulted in successful arrhythmia termination. This approach can be easily incorporated into clinical practice. (C) 2020 by the American College of Cardiology Foundation.
Filiaciones:
Font, ER:
Univ Autonoma Barcelona, Dept Cardiol, Arrhythmia Unit, CIBERCV,Hosp Santa Creu & St Pau,Inst Recerca HSC, Barcelona, Spain
Alonso-Martin, C:
Univ Autonoma Barcelona, Dept Cardiol, Arrhythmia Unit, CIBERCV,Hosp Santa Creu & St Pau,Inst Recerca HSC, Barcelona, Spain
Guerra, JM:
Univ Autonoma Barcelona, Dept Cardiol, Arrhythmia Unit, CIBERCV,Hosp Santa Creu & St Pau,Inst Recerca HSC, Barcelona, Spain
Garcia, BC:
Univ Autonoma Barcelona, Dept Cardiol, Arrhythmia Unit, CIBERCV,Hosp Santa Creu & St Pau,Inst Recerca HSC, Barcelona, Spain
Zurita, FM:
Univ Autonoma Barcelona, Dept Cardiol, Arrhythmia Unit, CIBERCV,Hosp Santa Creu & St Pau,Inst Recerca HSC, Barcelona, Spain
Rodriguez, OA:
Univ Autonoma Barcelona, Dept Cardiol, Arrhythmia Unit, CIBERCV,Hosp Santa Creu & St Pau,Inst Recerca HSC, Barcelona, Spain
Weidmann, ZM:
Univ Autonoma Barcelona, Dept Cardiol, Arrhythmia Unit, CIBERCV,Hosp Santa Creu & St Pau,Inst Recerca HSC, Barcelona, Spain
Viamonte, HE:
Univ Autonoma Barcelona, Dept Cardiol, Arrhythmia Unit, CIBERCV,Hosp Santa Creu & St Pau,Inst Recerca HSC, Barcelona, Spain
Rami, AE:
Univ Autonoma Barcelona, Dept Cardiol, Arrhythmia Unit, CIBERCV,Hosp Santa Creu & St Pau,Inst Recerca HSC, Barcelona, Spain
Chavez, JM:
Univ Autonoma Barcelona, Dept Cardiol, Arrhythmia Unit, CIBERCV,Hosp Santa Creu & St Pau,Inst Recerca HSC, Barcelona, Spain
Matos, CG:
Univ Autonoma Barcelona, Dept Cardiol, Arrhythmia Unit, CIBERCV,Hosp Santa Creu & St Pau,Inst Recerca HSC, Barcelona, Spain
Montoya, PT:
Univ Autonoma Barcelona, Dept Cardiol, Arrhythmia Unit, CIBERCV,Hosp Santa Creu & St Pau,Inst Recerca HSC, Barcelona, Spain
Prat, XV:
Univ Autonoma Barcelona, Dept Cardiol, Arrhythmia Unit, CIBERCV,Hosp Santa Creu & St Pau,Inst Recerca HSC, Barcelona, Spain
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