Acute and long-term results of PVI at antrum using a novel high-density mapping catheter without help of 3D electro-anatomic mapping in patients with paroxysmal and chronic atrial fibrillation

2010 ◽  
Vol 27 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Thomas Neumann ◽  
Malte Kuniss ◽  
Damir Erkapic ◽  
Sergey Zaltsberg ◽  
Alexander Berkowitsch ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Atrial Fibrillation ◽  
High Density ◽  
Long Term Results ◽  
Density Mapping ◽  
Mapping Catheter

P3778Long-term outcome of non-pharmacologial treatment of atrial fibrillation in hypertrophic cardiomyopathy: a large single-centre experience

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Dinshaw ◽  
M Lemoine ◽  
J Hartmann ◽  
B Schaeffer ◽  
N Klatt ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Atrial ◽  
High Density ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Density Mapping ◽  
Ablation Success

Abstract Introduction Atrial fibrillation (AF) is common in hypertrophic cardiomyopathy (HCM) and is generally associated with a significant deterioration of clinical status. Non-pharmacological treatment such as surgical and catheter ablation has become an established therapy for symptomatic AF but in patients with HCM often having a chronically increased left atrial pressure and extensive atrial cardiomyopathy the long-term outcome is uncertain. Purpose The present study aimed to analyse the long-term outcome of AF ablation in HCM and the mechanism of recurrent atrial arrhythmias using high-density mapping systems. Methods A total of 65 patients (age 64.5±9.9 years, 42 (64.6%) male) with HCM undergoing AF ablation for symptomatic AF were included in our study. The ablation strategy for catheter ablation included pulmonary vein isolation in all patients and biatrial ablation of complex fractionated electrograms with additional ablation lines if appropriate. In patients with suspected atrial tachycardia (AT) high-density activation and substrate mapping were performed. A surgical ablation at the time of an operative myectomy for left ventricular outflow tract obstruction was performed in 8 (12.3%) patients. The outcome was analysed using clinical assessment, Holter ECG and continuous rhythm monitoring of cardiac implantable electric devices. Results Paroxysmal AF was present in 27 (41.6%), persistent AF in 37 (56.9%) and primary AT in 1 (1.5%) patients. The mean left atrial diameter was 54.1±12.5 ml. In 11 (16.9%) patients with AT high-density mapping was used to characterize the mechanism of the ongoing tachycardia. After 1.9±1.2 ablation procedures and a follow-up of 48.5±37.2 months, ablation success was demonstrated in 58.9% of patients. The success rate for paroxysmal and persistent AF was 70.0% and 55.8%, respectively (p=0.023). Of those patients with AT high-density mapping guided ablation was successful in 44.4% of patients. The LA diameter of patients with a successful ablation was smaller (52.2 vs. 58.1 mm; p=0.003). Conclusion Non-pharmacological treatment of AF in HCM is effective during long-term follow-up. Paroxysmal AF and a smaller LA diameter are favourable for successful ablation. In patients with complex AT the use of high-density mapping can guide ablation resulting in further ablation success in a reasonable number of patients.

P1377Substrate-based ablation in patients with frequent appropriate ICD therapy and dilated cardiomyopathy: long-term experience with high-density mapping

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
M M O Oliveira ◽  
P S C Cunha ◽  
B V Valente ◽  
G Portugal ◽  
A Lousinha ◽  
...  
Keyword(s):  
Left Ventricular ◽  
High Density ◽  
Border Zone ◽  
Long Term Results ◽  
Icd Therapy ◽  
Electroanatomic Mapping System ◽  
Density Mapping ◽  
Substrate Modification ◽  
Lv Dysfunction

Abstract Recurrent ventricular tachydisrhythmias (VT) episodes have a negative impact in the outcome of patients (P) already with an implantable cardioverter-defibrillator (ICD). Elimination of arrhythmic reentry circuits represents a difficult challenge, mainly due to the induction of intolerable VTs, with multiple ECG morphologies, requiring rapid interruption. Substrate guided ablation has been used as a promising approach strategy to treat recurrent VTs. Aim: to assess long-term results of a VT substrate-based ablation using high-density mapping in P with an ICD, severe left ventricular (LV)  dysfunction and recurrent appropriate ICD therapy. Methods: 16P (12 men, non-ischemic cardiomyopathy 67%, 55 ± 13 years, LV ejection fraction 32 ± 6%) and recurrent appropriate shocks despite antiarrhythmic drug therapy and optimal heart failure medication. All P underwent a protocol of ventricular programmed stimulation (600 ms/S3) to obtain baseline VT documentation. A sinus rhythm (SR) voltage map was created using a 3D electroanatomic mapping system (CARTO) with a high-density mapping catheter (PentaRay) to delineate areas of scarred myocardium (ventricular bipolar voltage ≤0,5 mV – dense scar; 0,5-1,5 mV – border zone; ≥1,5 mV – healthy tissue) and provide high-resolution electrophysiological mapping. The substrate modification included catheter elimination of local abnormal ventricular activities (LAVA) - fractionated, splited, low-amplitude/long-lasting, late potentials, pre-systolic potentials - and linear ablation to obtain scars homogenization and scar dechanneling. Pace-mapping techniques were used when capture was possible. LV approach was retrograde in 6 cases, transeptal in 4 and endo-epicardial in 2 cases. In 2P the ablation was performed in the right ventricle. Results: VTs were induced and interrupted with bursts or external DC shocks. LAVA were identified and ablated in all P. Eleven P underwent modification of scar areas. The mean duration of the procedure was 153 mn (103-218 mn), with radiofrequency ranging from 18 to 60 mn (mean 33 min), and a mean fluoroscopy time of 16 mn. Non-inducibility was achieved in 75% of the cases. There was 1 pericardial tamponade drained successfully. During a follow-up of 48 ± 18 months, 75% had no VT recurrences, 2P underwent redo ablation, 1P died from stroke. Conclusion: Catheter ablation of VT based on substrate modification guided by high-density mapping is feasible and safe in P with LV dysfunction. This approach may be of clinical relevance, with potential benefits in reducing VT burden.

scholarly journals Long-term results of atrial compartment operation for chronic atrial fibrillation in mitral valve disease

1996 ◽  
Vol 27 (2) ◽  
pp. 188 ◽  
Author(s):  
Fang-Yue Lin ◽  
Huey-Ming Lo ◽  
Jiunn-Lee Lin ◽  
Juey-Jen Hwang ◽  
Shoei K.Stephen Huang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Mitral Valve Disease ◽  
Chronic Atrial Fibrillation ◽  
Valve Disease ◽  
Long Term Results

High-density mapping in patients undergoing ablation of atrial fibrillation with the fourth-generation cryoballoon and the new spiral mapping catheter

EP Europace ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. 1653-1658
Author(s):  
Giulio Conte ◽  
Kyoko Soejima ◽  
Carlo de Asmundis ◽  
Jolie Bruno ◽  
Fabio Cattaneo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
High Density ◽  
Fourth Generation ◽  
Cryoballoon Ablation ◽  
Density Mapping ◽  
Basket Catheter ◽  
Significant Difference ◽  
Discrepancy Rate ◽  
Mapping Catheter

Abstract Aims To assess the value of high-density mapping (HDM) in revealing undetected incomplete pulmonary vein isolation (PVI) after the fourth-generation cryoballoon (CB4G) ablation compared to the previous cryoballoon’s versions. Methods and results Consecutive patients with paroxysmal or early-persistent atrial fibrillation (AF) undergoing CB ablation as the index procedure, assisted by HDM, were retrospectively included in this study. A total of 68 patients (52 males; mean age: 60 ± 12 years, 58 paroxysmal AF) were included, and a total of 272 veins were mapped. Fourth-generation cryoballoon with the new spiral mapping catheter (SMC) was used in 35 patients (51%). Time to PVI was determined in 102/132 (77%) and in 112/140 (80%) veins during second-generation cryoballoon/third-generation cryoballoon (CB2G/CB3G) and CB4G ablation, respectively (P = 0.66). There was a statistically significant difference in terms of discrepancy rate between the SMC and the mini-basket catheter in PV detection after CB4G and CB2G/CB3G ablation(1.4% vs. 7.6%; P = 0.01). A total of 57 patients (84%) remained free of symptomatic AF during a mean follow-up of 9.8 ± 4.6 months. Conclusion High-density mapping after cryoballoon ablation using CB4G and the new SMC identifies incomplete PVI, not detected by the new SMC, in a significantly lower proportion of veins compared to HDM performed after the other generation CB ablation.

Long-Term Results of Cryoablation with a New Cryoprobe to Eliminate Chronic Atrial Fibrillation Associated with Mitral Valve Disease

2005 ◽  
Vol 28 (s1) ◽  
pp. S73-S77 ◽  
Author(s):  
HIROSHI TADA ◽  
SACHIKO ITO ◽  
SHIGETO NAITO ◽  
YUTAKA HASEGAWA ◽  
KENJI KUROSAKI ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Mitral Valve Disease ◽  
Chronic Atrial Fibrillation ◽  
Valve Disease ◽  
Long Term Results

scholarly journals Long-Term Results after the Box Pulmonary Vein Isolation Procedure for Chronic Atrial Fibrillation in Mitral Valve Surgery

2012 ◽  
Vol 18 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Taijiro Sueda ◽  
Naomichi Uchida ◽  
Taiichi Takasaki ◽  
Shinya Takahashi ◽  
Tatsuya Kurosaki ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Chronic Atrial Fibrillation ◽  
Mitral Valve Surgery ◽  
Isolation Procedure ◽  
Valve Surgery ◽  
Long Term Results
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