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Electroanatomic mapping

Maciej Kubala, Rajeev K Pathak, Shuanglun Xie, Ruben Casado Arroyo, Cory M Tschabrunn, Tatsuya Hayashi, Fermin C Garcia, Gregory E Supple, Pasquale Santangeli, David S Frankel, Erica S Zado, David J Callans, Francis E Marchlinski
BACKGROUND: Repolarization abnormalities in arrhythmogenic right ventricular (RV) cardiomyopathy and their relationship to ventricular tachycardia substrate are incompletely understood. METHODS AND RESULTS: In 40 patients (29 men, mean age 38 years) with arrhythmogenic RV cardiomyopathy, we compared the extent and location of abnormal T (NegT) waves ≥1 mm in depth (n=32) and downsloping elevated ST segment (n=13), in ≥2 adjacent leads, to area and location of endocardial bipolar (<1...
March 2018: Circulation. Arrhythmia and Electrophysiology
Yang Liu, Xiao-Hui Niu, Xiaomeng Yin, Yue-Jian Liu, Chao Han, Jie Yang, Xin Huang, Xiaohong Yu, Lianjun Gao, Yan-Zong Yang, Yun-Long Xia, Hui-Hua Li
BACKGROUND: In atrial fibrillation (AF), a more extensively fibrotic left atrium (LA) provides a substrate for arrhythmias and increases risk of relapse following ablation. Fibrocytes are bone marrow-derived circulating mesenchymal progenitors that have been identified in the atrium of patients with AF who have valvular diseases. The present study investigates the associations between circulating fibrocytes and LA fibrosis or the prevalence of recurrence after ablation in patients with persistent AF...
March 13, 2018: Journal of the American Heart Association
Katie A Walsh, Joseph Galvin, John Keaney, Edward Keelan, Gabor Szeplaki
AIMS: Zero- and near-zero-fluoroscopic ablation techniques reduce the harmful effects of ionizing radiation during invasive electrophysiology procedures. We aimed to test the feasibility and safety of a zero-fluoroscopic strategy using a novel integrated magnetic and impedance-based electroanatomical mapping system for radiofrequency ablation (RFA) of supraventricular tachycardias (SVTs). METHODS: We retrospectively studied 92 consecutive patients undergoing electrophysiology studies with/without RFA for supraventricular tachycardia (SVT) performed by a single operator at a single center...
February 23, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Shinsuke Miyazaki, Takatsugu Kajiyama, Tomonori Watanabe, Sadamitsu Ichijo, Yoshito Iesaka
Isolation areas post-28-mm cryoballoon pulmonary vein isolation (CB-PVI) are smaller than post-radiofrequency PV antrum isolation at the left superior PV (LSPV) antrum and recurrent atrial fibrillation (AF) can originate from this area. This pilot study evaluated the impact of additional extra-PV CB applications at the LSPV antrum following conventional CB-PVI. Eighteen paroxysmal AF patients underwent CB-PVI with single 3-min freeze techniques. Following the CB-PVI, 2-min CB applications were added once or twice at the LSPV antrum...
February 20, 2018: Heart and Vessels
Roland Richard Tilz, Christian-Hendrik Heeger, Alexander Wick, Ardan M Saguner, Andreas Metzner, Andreas Rillig, Peter Wohlmuth, Bruno Reissmann, Christine Lemeš, Tilman Maurer, Francesco Santoro, Johannes Riedl, Christian Sohns, Shibu Mathew, Karl-Heinz Kuck, Feifan Ouyang
BACKGROUND: Circumferential pulmonary vein isolation (CPVI) is increasingly performed for the treatment of symptomatic drug-refractory paroxysmal atrial fibrillation. Long-term data for >10 years after CPVI are sparse. We investigated the long-term clinical outcome and progression of paroxysmal atrial fibrillation after double-lasso and 3-dimensional electroanatomical mapping-guided CPVI. METHODS AND RESULTS: From 2003 to 2004, 161 patients (mean age: 60±10 years) with symptomatic drug-refractory paroxysmal atrial fibrillation were prospectively enrolled and underwent electroanatomical mapping-guided CPVI...
February 2018: Circulation. Arrhythmia and Electrophysiology
Choukri Mekkaoui, Marcel P Jackowski, William J Kostis, Christian T Stoeck, Aravinda Thiagalingam, Timothy G Reese, Vivek Y Reddy, Jeremy N Ruskin, Sebastian Kozerke, David E Sosnovik
BACKGROUND: Late gadolinium enhancement (LGE) is the current standard for myocardial scar delineation. In this study, we introduce the tractographic propagation angle (PA), a metric of myofiber curvature (degrees/unit distance) derived from diffusion tensor imaging (DTI), and compare its use to LGE and invasive scar assessment by endocardial voltage mapping. METHODS AND RESULTS: DTI was performed on 7 healthy human volunteers, 5 patients with myocardial infarction, 6 normal mice, and 7 mice with myocardial infarction...
February 2, 2018: Journal of the American Heart Association
Jonathan Chrispin, Ali Keramati, Fabrizio R Assis, Satish Misra, Tarek Zghaib, Ronald D Berger, Hugh Calkins, Harikrishna Tandri
AIMS: Prior studies identified a relationship between epicardial bipolar and endocardial unipolar voltage. Whether the relationship is valid with smaller multielectrode mapping catheters has not been reported. We explored the association of right ventricular (RV) endocardial unipolar voltage mapping with epicardial bipolar voltage mapping using a multielectrode mapping catheter. METHODS: Electrograms from patients who underwent multielectrode endocardial and epicardial RV electroanatomical mapping during ablation procedures were analyzed...
February 6, 2018: Pacing and Clinical Electrophysiology: PACE
Christopher Piorkowski, Arash Arya, Craig D Markovitz, Hedi Razavi, Chunlan Jiang, Stuart Rosenberg, Ole-A Breithardt, Sascha Rolf, Silke John, Jedrzej Kosiuk, Yan Huo, Michael Döring, Sergio Richter, Kyungmoo Ryu, Thomas Gaspar, Frits W Prinzen, Gerhard Hindricks, Philipp Sommer
PURPOSE: Cardiac disease frequently has a degenerative effect on cardiac pump function and regional myocardial contraction. Therefore, an accurate assessment of regional wall motion is a measure of the extent and severity of the disease. We sought to further validate an intra-operative, sensor-based technology for measuring wall motion and strain by characterizing left ventricular (LV) mechanical and electrical activation patterns in patients with normal (NSF) and impaired systolic function (ISF)...
January 31, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Michael Ghannam, Hubert Cochet, Pierre Jais, Maxime Sermesant, Smita Patel, Konstantinos C Siontis, Fred Morady, Frank Bogun
BACKGROUND: Myocardial wall thickness (WT) in patients with a prior myocardial infarction has been used to indicate scarring. However, the correlation of WT with sites critical to ventricular tachycardia (VT) has not been previously investigated. The purpose of this study was to correlate electroanatomic mapping data obtained during VT ablation with WT determined by cardiac computed tomography (CT). METHODS AND RESULTS: Cardiac CTs were performed in 15 consecutive patients (mean age 63±10 years, 86% male, left ventricular ejection fraction 27±12%) with a prior infarct referred for VT ablation...
January 30, 2018: Journal of Cardiovascular Electrophysiology
Sabina Frljak, Martina Jaklic, Gregor Zemljic, Andraz Cerar, Gregor Poglajen, Bojan Vrtovec
We investigated the effects of CD34+cell therapy on right ventricular (RV) function in patients with nonischemic dilated cardiomyopathy (DCM). We enrolled 60 patients with DCM who were randomized to CD34+cell therapy (Stem Cells (SC) Group n = 30), or no cell therapy (Controls, n = 30). The SC Group received granulocyte-colony stimulating factor, and CD34+cells were collected by apheresis and injected transendocardially. Patients were followed for 6 months. At baseline, the groups did not differ in age, gender, left ventricular ejection fraction, N-terminal probrain natriuretic peptide, or parameters of RV function...
February 2018: Stem Cells Translational Medicine
Philipp Sommer, Livio Bertagnolli, Simon Kircher, Arash Arya, Andreas Bollmann, Sergio Richter, Sascha Rolf, Gerhard Hindricks
Aims: Efforts to reduce radiation exposure during catheter ablation procedures have included the use of various technological measures. Significant results have been achieved to the point where near lead-free procedures in routine clinical practice has become a realistic goal. The integration of MediGuide technology [non-fluoroscopic catheter visualization technology (NFCV)] and three-dimensional electroanatomical mapping is one of the methods developed in response to radiation reduction initiatives...
January 16, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Domenico Grieco, Zefferino Palamà, Alessio Borrelli, Ermenegildo De Ruvo, Luigi Sciarra, Antonio Scarà, Emilia Goanta, Vito Calabrese, Paolo Pozzilli, Germano Di Sciascio, Leonardo Calò
Complex fractionated atrial electrograms (CFAEs) are related to atrial fibrosis, but their ablation has not yet shown superiority. The aim of the study was to compare, in terms of clinical outcome, two strategies of paroxysmal atrial fibrillation (AF) ablation in patients with type 1 diabetes mellitus (DM): pulmonary vein isolation (PVI) vs. PVI + CFAEs. Compared to an historical population of patient with paroxysmal AF and without DM, a higher percentage of patients with DM showed more than 25% of atrial area interested by CFAEs (study population, 58% vs historical group, 15%; p < 0...
January 1, 2018: Diabetes & Vascular Disease Research
Avishag Laish-Farkash, Avi Sabbag, Michael Glikson, Aharon Glick, Vladimir Khalameizer, Amos Katz, Yoav Michowitz
BACKGROUND: Multiform fascicular tachycardia (FT) was recently described as a ventricular tachycardia (VT) that has a reentrant mechanism using multiple fascicular branches and produces alternate fascicular VT forms. Ablating the respective fascicle may cause a change in the reentrant circuit resulting in a change in morphology. Ablation of the septal fascicle is crucial for successful treatment. OBJECTIVES: To describe four cases of FT in which ablation induced a change in QRS morphologies and aggravated clinical course...
January 2018: Israel Medical Association Journal: IMAJ
Chao-Feng Chen, Xiao-Hua Liu, Xiao-Fei Gao, Bin Chen, Yi-Zhou Xu
BACKGROUND: Premature ventricular contractions (PVCs) originating from aortic sinus cusps is not infrequent and can be eliminated effectively by radiofrequency ablation with rare complications. However, after a review of the medical literature, and to our knowledge, this is the first case of successful idiopathic aortic sinus cusps-PVC-ablation using a 3-dimensional (3D) mapping system in an adult with dextrocardia. METHODS: A 62-year-old male with dextrocardia and situs inversus underwent catheter ablation of frequent PVCs...
December 2017: Medicine (Baltimore)
Kentaro Minami, Koji Kumagai, Yoshinao Sugai, Kohki Nakamura, Shigeto Naito, Shigeru Oshima
In patients with atrial fibrillation (AF) having congenital anatomical abnormalities, such as complete situs inversus and dextrocardia, pulmonary vein isolation (PVI) ablation can be performed safety using a three-dimensional electroanatomical mapping system. However, it is not clear whether a three-dimensional electroanatomical mapping system can be used to detect non-PV ectopic beats initiating AF in patients with complete situs inversus and dextrocardia. Here, we report a 21-year-old man with complete situs inversus and dextrocardia, who showed AF caused by non-PV ectopic beats...
December 21, 2017: Indian Pacing and Electrophysiology Journal
Andres Enriquez, Jackson J Liang, Pasquale Santangeli, Francis E Marchlinski, Michael P Riley
We report the case of a 66 year-old male who underwent catheter ablation for drug-refractory paroxysmal atrial fibrillation (AF) at our institution. Radiofrequency catheter ablation was performed using a three-dimensional electroanatomical mapping system. During ablation of the pulmonary veins (PV), right atrial ectopics were noted to repeatedly trigger AF and atrial tachycardia (AT). After PV isolation, mapping of the right atrium revealed that the superior vena cava (SVC) was in AF, while both atria were in an organized AT...
April 2017: Journal of Atrial Fibrillation
Usama Boles, Enes E Gul, Andres Enriquez, Howard Lee, Dave Riegert, Adrian Andres, Adrian Baranchuk, Damian Redfearn, Benedict Glover, Chris Simpson, Hoshiar Abdollah, Kevin Michael
Background: Ablation of the pulmonary vein (PV) antrum using an electroanatomic mapping system is standard of care for point-by-point pulmonary vein isolation (PVI). Focused ablation at critical areas is more likely to achieve intra-procedural PV isolation and decrease the likelihood for reconnection and recurrence of atrial fibrillation (AF). Therefore this prospective pilot study is to investigate the short-term outcome of a voltage-guided circumferential PV ablation (CPVA) strategy...
February 2017: Journal of Atrial Fibrillation
Aleksei S Kovalev, Leo A Bockeria, Andrey G Filatov
Atrial fibrillation (AF) is the most common arrhythmia in the population. Still there is no unity in understanding of mechanisms and their influence on catheter ablation results. In our study we tried to evaluate accurate initial quantitative indicators of electromechanical remodeling that can border patients from expected good to expected poor results of catheter ablation. We performed electroanatomical mapping and ablation procedures in 94 patient (45 female) in 2012 with 3-year follow-up period. The target points were left atria surface area, complex fragmentation atrial electrograms (CFAE) duration and surface area...
February 2017: Journal of Atrial Fibrillation
Minglong Chen
Laboratory studies, histology studies, image studies and the clinical studies all prove the positive correlation between atrial fibrillation and atrial fibrosis from different perspectives. Atrial fibrosis, by separating myocardial cell coupling, diminishing conduction velocity and promoting anisotropic conduction, produce the substrate to sustain atrial fibrillation (AF). These fibrotic areas can be translated into signal abnormalities (low voltage and complex electrgram), and be depicted by electroanatomic high density map...
June 2017: Journal of Atrial Fibrillation
Onur Kaypakli, Hasan Koca, Durmus Yıldıray Sahin, Fadime Karataş, Suleyman Ozbicer, Mevlüt Koç
AIM: The correct estimation of the VA origin as RVOT or LVOT results in reduced ablation duration reduced radiation exposure and decreased number of vascular access. In our study, we aimed to detect the predictive value of S-R difference in V1-V2 for differentiating the left from right ventricular outflow tract arrhythmias. METHODS: We included 123 patients with symptomatic frequent premature ventricular outflow tract contractions who underwent successful catheter ablation (70 male, 53 female; mean age 46...
December 10, 2017: Annals of Noninvasive Electrocardiology
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