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High Resolution Electroanatomical mapping

Akio Chikata, Takeshi Kato, Kazuo Usuda, Shuhei Fujita, Michiro Maruyama, Yoshiki Nagata, Satoru Sakagami, Naomi Kanamori, Takanori Yaegashi, Takahiro Saeki, Takashi Kusayama, Soichiro Usui, Hiroshi Furusho, Shuichi Kaneko, Masayuki Takamura
BACKGROUND: The impact of left atrial (LA) size on isolation area (ISA) using a 28-mm second-generation cryoballoon (CB) in the acute phase after pulmonary vein isolation (PVI) and the differences of CB from contact force-guided radiofrequency (RF) ablation have not been fully investigated. METHODS: We examined 85 consecutive patients (CB group, 35; RF group, 50) with drug-refractory paroxysmal atrial fibrillation who underwent their first PVI procedure at two institutions...
March 31, 2018: Pacing and Clinical Electrophysiology: PACE
Elvis Teijeira-Fernandez, Hubert Cochet, Felix Bourier, Masateru Takigawa, Ghassen Cheniti, Nathaniel Thompson, Antonio Frontera, Claudia Camaioni, Gregoire Massouille, Zakaria Jalal, Nicolas Derval, Xavier Iriart, Arnaud Denis, Meleze Hocini, Michel Haissaguerre, Pierre Jais, Jean-Benoit Thambo, Frederic Sacher
BACKGROUND: Voltage criteria for ventricular mapping have been obtained from small series of patients and prioritizing high specificity. OBJECTIVE: Using tetralogy of Fallot as a model of transmural right ventricular (RV) scar and MRI as reference, we aimed to study the potential influence of contact force (CF) on voltage mapping and to define voltage cutoff values for RV scar. METHODS: Fourteen patients (age 32.6±14.3, 5 female) with repaired tetralogy of Fallot underwent high resolution cardiac MRI (1...
March 20, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Konstantinos Vlachos, Michael Efremidis, Konstantinos P Letsas, George Bazoukis, Ruairidh Martin, Maria Kalafateli, Louiza Lioni, Stamatis Georgopoulos, Athanasios Saplaouras, Theodore Efremidis, Tong Liu, Kosmas Valkanas, Nikolaos Karamichalakis, Dimitrios Asvestas, Antonios Sideris
INTRODUCTION: We aimed to evaluate the extent of atrial fibrosis in paroxysmal atrial fibrillation (AF) and the correlation with ablation outcomes after pulmonary vein antral isolation (PVΑI) using a mapping system with high-resolution and high-spatial sampling. METHODS AND RESULTS: We prospectively enrolled 80 consecutive patients (45 males, median age 60.26 years) with symptomatic paroxysmal AF who were scheduled for PVAI. Prior to PVAI, high-density bipolar voltage mapping (median number of 2,485 points) was carried out during sinus rhythm in all patients...
December 2017: Journal of Cardiovascular Electrophysiology
Paul Chun Yih Lim, Koonlawee Nademanee, Edward Chun Yi Lee, Wee Siong Teo
We report a case of epicardial ablation in a combined Brugada and inferior early repolarization syndrome patient with recurrent defibrillator therapy for spontaneous ventricular fibrillation. Electroanatomic mapping and ablation were achieved with remote magnetic navigation. Highly fractionated electrograms were seen epicardially in the anterior right ventricular outflow tract (RVOT) and at the anterior-inferior right ventricle. Ablation of the RVOT region resulted in resolution Brugada pattern electrocardiogram...
February 2018: Pacing and Clinical Electrophysiology: PACE
Laura Rottner, Andreas Metzner, Feifan Ouyang, Christian Heeger, Kentaro Hayashi, Thomas Fink, Christine Lemes, Shibu Mathew, Tilman Maurer, Bruno REIßMANN, Enida Rexha, Johannes Riedl, Ardan M Saguner, Francesco Santoro, Karl-Heinz Kuck, Christian Sohns
INTRODUCTION: Three-dimensional electroanatomical mapping (EAM) is an established tool facilitating catheter ablation. In this context, the novel Rhythmia system sets a new bar in fast high-resolution mapping. The aim of this study was to directly compare point-by-point versus rapid ultra-high-resolution EAM in patients scheduled for ablation of atrial fibrillation (AF) with focus on procedural data, acute success, and midterm clinical outcome. METHODS AND RESULTS: A total number of 74 consecutive patients (48/74 male) with symptomatic AF were scheduled to undergo pulmonary vein isolation (PVI) using either Carto or Rhythmia...
March 2017: Journal of Cardiovascular Electrophysiology
Jedrzej Kosiuk, Sebastian Hilbert, Silke John, Livio Bertagnolli, Gerhard Hindricks, Andreas Bollmann
BACKGROUND: Recently, a novel electroanatomic mapping system enabling rapid and automatic acquisition of high-resolution maps has been introduced. Previous reports focused on system use in combination with a mini-basket catheter. However, a novel system-specific, magnet-enabled ablation catheter eliminates the need for the mini-basket catheter and can potentially reduce procedure complexity and cost. Here we present our first experience from two consecutive case series using both procedural settings...
February 1, 2017: International Journal of Cardiology
Karthik Viswanathan, Lilian Mantziari, Charles Butcher, Emily Hodkinson, Eric Lim, Habib Khan, Sandeep Panikker, Shouvik Haldar, Julian W E Jarman, David G Jones, Wajid Hussain, John P Foran, Vias Markides, Tom Wong
BACKGROUND: The mapping of ventricular arrhythmias in humans using a minibasket 64-electrode catheter paired with a novel automatic mapping system (Rhythmia) has not been evaluated. OBJECTIVE: The purpose of this study was to evaluate the safety and efficacy of mapping ventricular arrhythmias and clinical outcomes after ablation using this system. METHODS: Electroanatomic maps for ventricular arrhythmias were obtained during 20 consecutive procedures in 19 patients (12 with ventricular tachycardia [VT] and 2 with ventricular ectopy [VE])...
February 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Christian Sohns, Ardan M Saguner, Christine Lemes, Francesco Santoro, Shibu Mathew, Christian Heeger, Bruno Reißmann, Tilman Maurer, Johannes Riedl, Thomas Fink, Kentaro Hayashi, Feifan Ouyang, Karl-Heinz Kuck, Andreas Metzner
BACKGROUND: The Rhythmia mapping system was recently launched and allows for rapid ultra-high-resolution electroanatomical mapping. We evaluated the feasibility, acute efficacy and safety of this novel system for ablation of atrial fibrillation (AF) and left atrial (LA) tachycardia (AT). METHODS AND RESULTS: A total of 35 consecutive patients (age 64.3 ± 8.6 years, LA diameter 44.4 ± 5.8 mm) underwent catheter ablation for AF and/or AT. All procedures were performed using Rhythmia in conjunction with the Orion mini-basket catheter...
December 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Shinsuke Miyazaki, Hiroshi Taniguchi, Hitoshi Hachiya, Hiroaki Nakamura, Takamitsu Takagi, Jin Iwasawa, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: The post-second-generation cryoballoon (CB) ablation isolation area during the chronic phase has not been described. The aim of this study was to quantitatively evaluate the chronic-phase isolation area after 28-mm second-generation CB ablation and compare it to the estimated conventional radiofrequency circumferential pulmonary vein isolation (CPVI) line. METHODS AND RESULTS: Thirty-two patients with paroxysmal atrial fibrillation underwent pulmonary vein (PV) isolation using second-generation CB...
May 2016: Circulation. Arrhythmia and Electrophysiology
Zhong Chen, Rocio Cabrera-Lozoya, Jatin Relan, Manav Sohal, Anoop Shetty, Rashed Karim, Herve Delingette, Jaswinder Gill, Kawal Rhode, Nicholas Ayache, Peter Taggart, Christopher Aldo Rinaldi, Maxime Sermesant, Reza Razavi
INTRODUCTION: Computational modeling of cardiac arrhythmogenesis and arrhythmia maintenance has made a significant contribution to the understanding of the underlying mechanisms of arrhythmia. We hypothesized that a cardiac model using personalized electro-anatomical parameters could define the underlying ventricular tachycardia (VT) substrate and predict reentrant VT circuits. We used a combined modeling and clinical approach in order to validate the concept. METHODS AND RESULTS: Non-contact electroanatomic mapping studies were performed in 7 patients (5 ischemics, 2 non-ischemics)...
July 2016: Journal of Cardiovascular Electrophysiology
Andreas Bollmann, Sebastian Hilbert, Silke John, Jedrzej Kosiuk, Gerhard Hindricks
INTRODUCTION: Recently, an automatic, high-resolution mapping system has been presented to accurately and quickly identify right atrial geometry and activation patterns in animals, but human data are lacking. This study aims to assess the clinical feasibility and accuracy of high-density electroanatomical mapping of various RA arrhythmias. METHODS AND RESULTS: Electroanatomical maps of the RA (35 partial and 24 complete) were created in 23 patients using a novel mini-basket catheter with 64 electrodes and automatic electrogram annotation...
February 2016: Journal of Cardiovascular Electrophysiology
Amit K Mehrotra, David Callans
Treatment for ventricular tachycardia (VT) generally includes 1 or more of the following options: antiarrhythmic therapy, an implantable cardioverter-defibrillator and/or catheter ablation. Catheter ablation is performed with an electroanatomic mapping system to define the heart's 3D anatomy, as well as regions of scar. Radiofrequency energy is then applied to areas of abnormal substrate within which are located channels critical to the VT circuit. Cardiac magnetic resonance (CMR) imaging is a non-invasive modality that provides high-resolution images of cardiac structure and function...
2015: Circulation Journal: Official Journal of the Japanese Circulation Society
Sok-Sithikun Bun, Decebal Gabriel Latcu, Francis Marchlinski, Nadir Saoudi
Since its first description about one century ago, our understanding of atrial flutter (AFL) circuits has considerably evolved. One AFL circuit can have variable electrocardiographic (ECG) manifestations depending on the presence of pre-existing atrial lesions, or impaired atrial substrate. Conversely, different (right sided or even left sided) atrial circuits including different mechanisms (macroreentrant, microreentrant, or focal) can present with a very similar surface ECG manifestation. The development of efficient high-resolution electroanatomical mapping systems has improved our knowledge about AFL mechanisms, as well as facilitated their curative treatment with radiofrequency catheter ablation...
September 14, 2015: European Heart Journal
Anees Thajudeen, Warren M Jackman, Brian Stewart, Ivan Cokic, Hiroshi Nakagawa, Michael Shehata, Allen M Amorn, Avinash Kali, Ezh Liu, Doron Harlev, Nathan Bennett, Rohan Dharmakumar, Sumeet S Chugh, Xunzhang Wang
BACKGROUND: Endocardial mapping for scars and abnormal electrograms forms the most essential component of ventricular tachycardia ablation. The utility of ultra-high resolution mapping of ventricular scar was assessed using a multielectrode contact mapping system in a chronic canine infarct model. METHODS: Chronic infarcts were created in five anesthetized dogs by ligating the left anterior descending coronary artery. Late gadolinium-enhanced magnetic resonance imaging (LGE MRI) was obtained 4...
June 2015: Pacing and Clinical Electrophysiology: PACE
Andreas Bollmann, Sebastian Hilbert, Silke John, Jedrzej Kosiuk, Gerhard Hindricks
AIMS: Although sinus node modification by catheter ablation is an established therapy for the treatment of inappropriate sinus tachycardia, there is incomplete understanding of sinus node anatomy and function but also limited electroanatomical mapping data. Recently, an automatic, ultra high-resolution mapping system has been presented to accurately and quickly identify right atrial (RA) geometry and activation patterns but detailed assessment of sinus node activation has not been performed which was one aim of this study...
March 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Ursa Mikuz, Gregor Poglajen, Misa Fister, Vito Starc, Joseph C Wu, Henry Hsia, François Haddad, Bojan Vrtovec
BACKGROUND: We analyzed electromechanical mismatch (EMM) and its relationship to ventricular repolarization in patients with nonischemic dilated cardiomyopathy (DCM). METHODS AND RESULTS: In 39 DCM patients with left ventricular ejection fraction (LVEF) <40% and New York Heart Association functional class ≥III, electroanatomic mapping was used to quantify areas of EMM. High-resolution electrocardiograph was used to measure heart rate variability (HRV) and QT variability index (QTVI)...
December 2014: Journal of Cardiac Failure
Oleh Dzyubachyk, Qian Tao, Dirk H J Poot, Hildo J Lamb, Katja Zeppenfeld, Boudewijn P F Lelieveldt, Rob J van der Geest
PURPOSE: To develop and validate a method for improving image resolution of late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) for accurate assessment of myocardial scar. MATERIALS AND METHODS: In a cohort of 37 postinfarction patients, LGE was performed prior to ventricular tachycardia catheter ablation therapy at 1.5T. A super-resolution reconstruction (SRR) technique was applied to the three anisotropic views: short-axis (SA), two-chamber, and four-chamber, to reconstruct a single isotropic volume...
July 2015: Journal of Magnetic Resonance Imaging: JMRI
Yasuaki Tanaka, Martin Genet, Lik Chuan Lee, Alastair J Martin, Richard Sievers, Edward P Gerstenfeld
BACKGROUND: Standard electroanatomic mapping systems use a single catheter to perform left ventricular substrate mapping. A new mapping system uses a 64-electrode mini-basket catheter to perform rapid automated acquisition of chamber geometry, voltage, and activation. OBJECTIVE: The aim of this study was to compare the accuracy of electroanatomic mapping using the basket catheter with that of mapping using a standard linear catheter in a swine model of chronic myocardial infarction...
January 2015: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Yuki Komatsu, Amir Jadidi, Frederic Sacher, Arnaud Denis, Matthew Daly, Nicolas Derval, Ashok Shah, Heiko Lehrmann, Chan-Il Park, Reinhold Weber, Thomas Arentz, Gregor Pache, Maxime Sermesant, Nicholas Ayache, Jatin Relan, Michel Montaudon, François Laurent, Mélèze Hocini, Michel Haïssaguerre, Pierre Jaïs, Hubert Cochet
BACKGROUND: Myocardial fibrofatty infiltration is a milieu for ventricular tachycardia (VT) in arrhythmogenic right ventricular cardiomyopathy (ARVC) and can be depicted as myocardial hypodensity on contrast-enhanced multidetector computed tomography (MDCT) with high spatial and temporal resolution. This study aimed to assess the relationship between MDCT-imaged myocardial fat and VT substrate in ARVC. METHODS AND RESULTS: We studied 16 patients with ARVC who underwent ablation and preprocedural MDCT...
August 7, 2014: Journal of the American Heart Association
Michael Seger, Friedrich Hanser, Wolfgang Dichtl, Markus Stuehlinger, Florian Hintringer, Thomas Trieb, Bernhard Pfeifer, Thomas Berger
AIMS: The present study was aimed to assess epi- and endocardial ventricular electroanatomical activation during cardiac resynchronization therapy (CRT) by means of non-invasive imaging of cardiac electrophysiology (NICE) in a patient with a novel quadripolar LV lead. METHODS AND RESULTS: Non-invasive imaging of cardiac electrophysiology is a novel imaging tool which works by fusing data from high-resolution electrocardiogram (ECG) mapping with a model of the patient's individual cardiothoracic anatomy created from magnetic resonance imaging...
May 2014: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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