Characterization, Mapping, and Ablation of Complex Atrial Tachycardia: Initial Experience With a Novel Method of Ultra High-Density 3D Mapping
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Characterization, Mapping, and Ablation of Complex Atrial Tachycardia: Initial Experience With a Novel Method of Ultra High-Density 3D Mapping. / Schaeffer, Benjamin; Hoffmann, Boris A; Meyer, Christian; Akbulak, Ruken Ö; Moser, Julia; Jularic, Mario; Eickholt, Christian; Nührich, Jana M; Kuklik, Pawel; Willems, Stephan.
in: J CARDIOVASC ELECTR, Jahrgang 27, Nr. 10, 10.2016, S. 1139-1150.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Characterization, Mapping, and Ablation of Complex Atrial Tachycardia: Initial Experience With a Novel Method of Ultra High-Density 3D Mapping
AU - Schaeffer, Benjamin
AU - Hoffmann, Boris A
AU - Meyer, Christian
AU - Akbulak, Ruken Ö
AU - Moser, Julia
AU - Jularic, Mario
AU - Eickholt, Christian
AU - Nührich, Jana M
AU - Kuklik, Pawel
AU - Willems, Stephan
N1 - © 2016 Wiley Periodicals, Inc.
PY - 2016/10
Y1 - 2016/10
N2 - INTRODUCTION: Conventional mapping of complex atrial tachycardias (ATs) can be challenging. Thus, we evaluated feasibility and utility of a novel, ultra high-density 3D mapping approach to characterize and map AT in these cases.METHODS AND RESULTS: Overall, 21 patients (67.4 ± 7.6 years; male: 52.4%, 1.9 ± 1.4 previous ablation procedures) with documented AT referred to our center underwent catheter ablation including ultra high-density mapping using a novel 64-electrode mini-basket catheter and an adjunctive 3D mapping system. A total of 24 AT (20 left atrial, 4 right atrial AT) were analyzed in 19 cases. In 2 patients, map acquisition failed due to scarce local electrograms and unstable AT cycle length, respectively. Underlying mechanisms were focal (n = 3), as well as local (n = 8) and macro (n = 13) reentry tachycardias with a mean cycle length of 311.8 ± 67.7 milliseconds. The analysis of propagation waves, activation and voltage revealed complex activation patterns and allowed for the identification of critical sites of AT initiation or maintenance without the need for further mapping techniques. In all cases critical sites could be verified by successful consecutive ablation. Mean mapping time was 19.4 ± 7.6 minutes, mean number of mapping points was 19,217 ± 10,270. Radiofrequency application until first effect was 165.1 ± 374.2 seconds; total procedure time was 157.6 ± 51.4 minutes, fluoroscopy time 21.7 ± 13.8 minutes, and total radiofrequency duration 1,016 ± 951.9 seconds, respectively. No severe complications occurred.CONCLUSION: Ultra high-density mapping of complex AT is safe and feasible. Further, it enables detailed insight into AT mechanisms. Critical AT sites can be identified precisely in order to guide successful catheter ablation.
AB - INTRODUCTION: Conventional mapping of complex atrial tachycardias (ATs) can be challenging. Thus, we evaluated feasibility and utility of a novel, ultra high-density 3D mapping approach to characterize and map AT in these cases.METHODS AND RESULTS: Overall, 21 patients (67.4 ± 7.6 years; male: 52.4%, 1.9 ± 1.4 previous ablation procedures) with documented AT referred to our center underwent catheter ablation including ultra high-density mapping using a novel 64-electrode mini-basket catheter and an adjunctive 3D mapping system. A total of 24 AT (20 left atrial, 4 right atrial AT) were analyzed in 19 cases. In 2 patients, map acquisition failed due to scarce local electrograms and unstable AT cycle length, respectively. Underlying mechanisms were focal (n = 3), as well as local (n = 8) and macro (n = 13) reentry tachycardias with a mean cycle length of 311.8 ± 67.7 milliseconds. The analysis of propagation waves, activation and voltage revealed complex activation patterns and allowed for the identification of critical sites of AT initiation or maintenance without the need for further mapping techniques. In all cases critical sites could be verified by successful consecutive ablation. Mean mapping time was 19.4 ± 7.6 minutes, mean number of mapping points was 19,217 ± 10,270. Radiofrequency application until first effect was 165.1 ± 374.2 seconds; total procedure time was 157.6 ± 51.4 minutes, fluoroscopy time 21.7 ± 13.8 minutes, and total radiofrequency duration 1,016 ± 951.9 seconds, respectively. No severe complications occurred.CONCLUSION: Ultra high-density mapping of complex AT is safe and feasible. Further, it enables detailed insight into AT mechanisms. Critical AT sites can be identified precisely in order to guide successful catheter ablation.
KW - Action Potentials
KW - Aged
KW - Catheter Ablation/adverse effects
KW - Electrocardiography
KW - Electrophysiologic Techniques, Cardiac
KW - Feasibility Studies
KW - Female
KW - Heart Conduction System/physiopathology
KW - Heart Rate
KW - Humans
KW - Male
KW - Middle Aged
KW - Predictive Value of Tests
KW - Radiography, Interventional
KW - Tachycardia, Supraventricular/diagnosis
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1111/jce.13035
DO - 10.1111/jce.13035
M3 - SCORING: Journal article
C2 - 27325527
VL - 27
SP - 1139
EP - 1150
JO - J CARDIOVASC ELECTR
JF - J CARDIOVASC ELECTR
SN - 1045-3873
IS - 10
ER -
