Novel Mapping Technique for Localization of Focal and Reentrant Activation During Atrial Fibrillation

التفاصيل البيبلوغرافية
العنوان: Novel Mapping Technique for Localization of Focal and Reentrant Activation During Atrial Fibrillation
المؤلفون: Yoshihide Takahashi, Shinsuke Iwai, Masahito Suzuki, Mitsuaki Isobe, Yasuhiro Sato, Mayumi Masumura, Kento Yabe, Kenzo Hirao, Syu Yamashita
المصدر: Journal of Cardiovascular Electrophysiology. 28:375-382
بيانات النشر: Wiley, 2017.
سنة النشر: 2017
مصطلحات موضوعية: Wavefront, medicine.medical_specialty, business.industry, medicine.medical_treatment, Ripple, Atrial fibrillation, Reentry, 030204 cardiovascular system & hematology, medicine.disease, Ablation, Activation pattern, 03 medical and health sciences, 0302 clinical medicine, Reentrancy, Manual annotation, Physiology (medical), Internal medicine, cardiovascular system, medicine, Cardiology, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business
الوصف: INTRODUCTION Identification of wavefront propagation pattern during AF remains challenging in ablation procedures. We sought to test a novel combination of a new mapping technology called Ripple Map and high-density mapping to distinguish focal and reentrant activation during atrial fibrillation (AF). METHODS AND RESULTS Subjects were patients undergoing ablation for persistent AF. If AF remained after isolation of the pulmonary veins, the left atrium (LA) was mapped by a high-density mapping catheter for later analysis, after which ablation was continued using a conventional stepwise approach. After the procedure, electrograms from the high-density mapping catheter were analyzed using Ripple Map, which is a new feature in the CARTO®3, and type of activation on ≥3 consecutive AF cycles was determined. High-density mapping was performed on 569 sites in 45 patients (13 ± 3 sites per patient). AF wavefront propagation determined by Ripple Map was in good agreement with analysis of manual annotation of bipolar electrograms. Ripple Map's representation of wavefront activation pattern, which could include local as well as far-field activity, allowed us to identify focal activation in 64 (11%) sites and 1 (0.2%) reentrant activation site. Radiofrequency delivery in atrial regions with activation sites identified as focal by Ripple Map resulted in termination of AF more often than regions without focal activation (22% vs. 7%, P = 0.015). CONCLUSION This study demonstrated that Ripple Map enabled quick identification of AF wavefront activation pattern, potentially being helpful for determining ablation targets in persistent AF.
تدمد: 1045-3873
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::a8af97181740f4df87e3abef0c8bf1fb
https://doi.org/10.1111/jce.13163
حقوق: CLOSED
رقم الأكسشن: edsair.doi...........a8af97181740f4df87e3abef0c8bf1fb
قاعدة البيانات: OpenAIRE