Identification of repetitive atrial activation patterns in persistent atrial fibrillation by direct contact high‐density electrogram mapping

2019 ◽  
Vol 30 (12) ◽  
pp. 2704-2712 ◽  
Author(s):  
Michael Wolf ◽  
René Tavernier ◽  
Ziad Zeidan ◽  
Milad El Haddad ◽  
Yves Vandekerckhove ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Direct Contact ◽  
Persistent Atrial Fibrillation ◽  
High Density ◽  
Activation Patterns ◽  
Atrial Activation

Characterisation of Atrial Activation Patterns in Human Persistent Atrial Fibrillation: Multiple Wavelets or Focal Drivers?

2012 ◽  
Vol 21 ◽  
pp. S117-S118
Author(s):  
G. Lee ◽  
A. Teh ◽  
S. Kumar ◽  
A. Madry ◽  
S. Spence ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
Activation Patterns ◽  
Atrial Activation

Catheter Ablation of Low-Voltage Areas for Persistent Atrial Fibrillation: Procedural Outcomes Using High-Density Voltage Mapping

2020 ◽  
Vol 36 (12) ◽  
pp. 1956-1964 ◽  
Author(s):  
Pablo B. Nery ◽  
Wael Alqarawi ◽  
Girish M. Nair ◽  
Mouhannad M. Sadek ◽  
Calum J. Redpath ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Low Voltage ◽  
Persistent Atrial Fibrillation ◽  
High Density ◽  
Voltage Mapping ◽  
Procedural Outcomes

scholarly journals Endocardial-Epicardial Phase Mapping of Prolonged Persistent Atrial Fibrillation Recordings

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
Ramanathan Parameswaran ◽  
Jonathan M. Kalman ◽  
Alistair Royse ◽  
John Goldblatt ◽  
Marco Larobina ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
Temporal Heterogeneity ◽  
Activation Patterns ◽  
3 Dimensional ◽  
Transmural Migration ◽  
Endocardial Mapping ◽  
Phase Mapping ◽  
Insight Into ◽  
Activation Mapping

Background: Endocardial-epicardial dissociation and focal breakthroughs in humans with atrial fibrillation (AF) have been recently demonstrated using activation mapping of short 10-second AF segments. In the current study, we used simultaneous endo-epi phase mapping to characterize endo-epi activation patterns on long segments of human persistent AF. Methods: Simultaneous intraoperative mapping of endo- and epicardial lateral right atrium wall was performed in patients with persistent AF using 2 high-density grid catheters (16 electrodes, 3 mm spacing). Filtered unipolar and bipolar electrograms of continuous 2-minute AF recordings and electrodes locations were exported for phase analyses. We defined endocardial-epicardial dissociation as phase difference of ≥20 ms between paired endo-epi electrodes. Wavefronts were classified as rotations, single wavefronts, focal waves, or disorganized activity as per standard criteria. Endo-Epi wavefront patterns were simultaneously compared on dynamic phase maps. Complex fractionated electrograms were defined as bipolar electrograms with ≥5 directional changes occupying at least 70% of sample duration. Results: Fourteen patients with persistent AF undergoing cardiac surgery were included. Endocardial-epicardial dissociation was seen in 50.3% of phase maps with significant temporal heterogeneity. Disorganized activity (Endo: 41.3% versus Epi: 46.8%, P =0.0194) and single wavefronts (Endo: 31.3% versus Epi: 28.1%, P =0.129) were the dominant patterns. Transient rotations (Endo: 22% versus Epi: 19.2%, P =0.169; mean duration: 590±140 ms) and nonsustained focal waves (Endo: 1.2% versus Epi: 1.6%, P =0.669) were also observed. Apparent transmural migration of rotational activations (n=6) from the epi- to the endocardium was seen in 2 patients. Electrogram fractionation was significantly higher in the epicardium than endocardium (61.2% versus 51.6%, P <0.0001). Conclusions: Simultaneous endo-epi phase mapping of prolonged human persistent AF recordings shows significant Endocardial-epicardial dissociation marked temporal heterogeneity, discordant and transitioning wavefronts patterns and complex fractionations. No sustained focal activity was observed. Such complex 3-dimensional interactions provide insight into why endocardial mapping alone may not fully characterize the AF mechanism and why endocardial ablation may not be sufficient. Graphic Abstract: A graphic abstract is available for this article.

Spectral turbulence analysis of the signal-averaged electrocardiogram of the atrial activation as predictor of recurrence of idiopathic and persistent atrial fibrillation

2006 ◽  
Vol 107 (3) ◽  
pp. 307-316 ◽  
Author(s):  
Paulo Roberto Benchimol Barbosa ◽  
Alfredo de Souza Bomfim ◽  
Eduardo Corrêa Barbosa ◽  
Paulo Ginefra ◽  
Silvia Helena Cardoso Boghossian ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
Atrial Activation ◽  
Turbulence Analysis

scholarly journals 1157Sequential ultra-high density contact mapping shows increase of left atrial organization during persistent atrial fibrillation ablation

EP Europace ◽  
2017 ◽  
Vol 19 (suppl_3) ◽  
pp. iii245-iii245
Author(s):  
DG. Latcu ◽  
A. Amourha ◽  
B. Enache ◽  
SS. Bun ◽  
T. Delassi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Persistent Atrial Fibrillation ◽  
High Density ◽  
Atrial Fibrillation Ablation ◽  
Contact Mapping

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.

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