scholarly journals High‐Resolution Mapping and Ablation of Atrial Tachycardias Involving the Lateral Left Atrium

2021 ◽  
Author(s):  
Shinsuke Miyazaki ◽  
Kanae Hasegawa ◽  
Kazuya Yamao ◽  
Moe Mukai ◽  
Daisetsu Aoyama ◽  
...  
Keyword(s):  
High Resolution ◽  
Left Atrium ◽  
Superior Vena ◽  
Conduction Block ◽  
Vena Cava ◽  
Atrial Tachyarrhythmias ◽  
High Resolution Mapping ◽  
Complex Anatomy ◽  
Resolution Mapping

Background The lateral left atrium (LA) is often associated with atrial tachycardia (AT) because of its complex anatomy. We sought to characterize ATs associated with the lateral LA, including the posterolateral mitral isthmus (MI) and left atrial ridge. Methods and Results Twenty‐eight lateral LA‐associated ATs were mapped with high‐resolution mapping systems and entrainment pacing. The vein of Marshall was mapped with a 1.8‐Fr mapping catheter when possible. ATs were associated with the posterolateral MI in 18 ATs (14 perimitral, 3 small reentry, and 1 focal AT). All patients had undergone MI area ablation, and all ATs were successfully eliminated. During 27.0 (interquartile range, 10.5–40.0) months of follow‐up, all were free from any atrial tachyarrhythmias, with 3 patients on antiarrhythmics. Of 10 ATs involving the ridge or Marshall bundle, 3 were ridge related, 3 were Marshall bundle related based on vein of Marshall mapping, and 1 was a persistent left superior vena cava related AT. All 7 patients had undergone MI linear ablation. The critical isthmus was in the LA‐ridge junction or the LA‐Marshall bundle junction. Bidirectional conduction block between the LA and ridge or Marshall bundle was created. Two patients had the critical isthmus in the other area. The remaining patient had micro‐reentry in the ridge. All 10 ATs were terminated during ablation at the critical isthmus. During 12.0 (5.2–31.7) months of follow‐up, all were free from any atrial tachyarrhythmias, with 7 patients on antiarrhythmics. Conclusions Most ATs occurred after MI area ablation. An high resolution mapping‐guided approach is highly effective for identifying the mechanism.

scholarly journals Novel Ablation Strategy for Isolating the Superior Vena Cava Using Ultra High-Resolution Mapping

2018 ◽  
Vol 82 (8) ◽  
pp. 2007-2015 ◽  
Author(s):  
Yasuaki Tanaka ◽  
Atsushi Takahashi ◽  
Takamitsu Takagi ◽  
Jun Nakajima ◽  
Katsumasa Takagi ◽  
...  
Keyword(s):  
High Resolution ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
High Resolution Mapping ◽  
Resolution Mapping

Spiral activation of the superior vena cava: The utility of ultra-high-resolution mapping for caval isolation

Heart Rhythm ◽  
2018 ◽  
Vol 15 (2) ◽  
pp. 193-200 ◽  
Author(s):  
Seigo Yamashita ◽  
Michifumi Tokuda ◽  
Ryota Isogai ◽  
Kenichi Tokutake ◽  
Kenichi Yokoyama ◽  
...  
Keyword(s):  
High Resolution ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
High Resolution Mapping ◽  
Resolution Mapping

Abstract MP164: Electrophysiologic Conservation of Epicardial Conduction Dynamics After Myocardial Infarction in Newborn Piglets

2020 ◽  
Vol 127 (Suppl_1) ◽  
Author(s):  
Hanjay Wang ◽  
Terrence Pong ◽  
Haley Lucian ◽  
Joy Aparicio-Valenzuela ◽  
Yuko Tada ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
High Resolution ◽  
Electrical Conduction ◽  
Conduction Block ◽  
Cardiac Regeneration ◽  
Coronary Artery Ligation ◽  
Artery Ligation ◽  
Newborn Piglets ◽  
High Resolution Mapping ◽  
Resolution Mapping

Introduction: Newborn piglets reportedly exhibit natural heart regeneration after myocardial infarction (MI). However, the electrophysiologic properties of this regenerated muscle have not been examined. We hypothesized that epicardial electrical conduction is preserved after MI in newborn piglets. Methods: Yorkshire-Landrace piglets underwent left anterior descending coronary artery ligation on postnatal day 1 (P1, n=4) or postnatal day 7 (P7, n=7), infarcting the anteroseptal left ventricle through which the Purkinje conduction system passes. After 7 weeks, cardiac magnetic resonance imaging (MRI) was performed with late gadolinium enhancement for fibrosis analysis. Epicardial conduction mapping was performed using custom 3D-printed, 256-channel high-resolution mapping arrays (Fig 1A). Age- and weight-matched healthy pigs served as controls (n=7). Data are expressed as mean±SD. Results: MRI analysis revealed significant differences between the control, P1, and P7 groups in ejection fraction (47.6±3.1% vs 37.6±3.3% vs 30.2±6.6%, p<0.001, Fig 1B) and the degree of transmural anteroseptal LV scar (0.0±0.0% vs 9.1±5.4% vs 15.4±4.2%, p<0.001), respectively. Evidence of infarcted myocardium was identified with high-resolution mapping in the P1 and P7 piglets (black arrows, Fig 1C-F). Epicardial electrical conduction was preserved in control and all P1 pigs (Figs 1C-D), whereas variable conduction block or aberrant propagation were observed in all P7 pigs (Fig 1E-F, p=0.001). Conclusion: P1 piglets exhibited incomplete natural cardiac regeneration after MI but nevertheless demonstrated electrophysiologic conservation of epicardial conduction dynamics.

scholarly journals A new method of superior vena cava isolation without phrenic nerve injury by longitudinal ablation parallel to the phrenic nerve: a case report

2020 ◽  
Vol 4 (5) ◽  
pp. 1-4
Author(s):  
Tomoyuki Arai ◽  
Rintaro Hojo ◽  
Takeshi Kitamura ◽  
Seiji Fukamizu
Keyword(s):  
Superior Vena Cava ◽  
Phrenic Nerve ◽  
Compound Muscle Action Potential ◽  
Superior Vena ◽  
Conduction Block ◽  
Vena Cava ◽  
Major Complication ◽  
Muscle Action Potential ◽  
The Right

Abstract Background Superior vena cava (SVC) isolation has improved the outcomes of paroxysmal atrial fibrillation (AF) originating from the SVC. However, right phrenic nerve (PN) injury is a major complication of this procedure. Therefore, in cases where the right atrium (RA)-SVC conduction site is near the PN, tremendous care is required to prevent PN injury. Case summary Repeated SVC isolation was performed due to the recurrence of SVC-triggered AF. The RA-SVC activation map revealed that the partial conduction block line was detected, and the propagation broke through the gap at the course of the PN site from the RA to the SVC. Since the course of the PN identified at high-output pacing was wide, the SVC was isolated by making longitudinal lines on both sides of the PN in a cranial direction, except for where low-output pacing captured, confirming compound muscle action potential to detect PN injury. Eventually, the SVC was successfully isolated without PN injury, and the sinus rhythm was maintained without antiarrhythmic drugs during a 14-month follow-up period. Conclusion Superior vena cava isolation was difficult depending on the course of the PN, and some methods to avoid PN injury were reported. However, this method can facilitate safe and effective SVC isolation with the conventional system, including the cases with AF foci located on the course of the PN.

Spatial and temporal variations in pacemaking and conduction in the isolated renal pelvis

1996 ◽  
Vol 270 (4) ◽  
pp. F567-F574 ◽  
Author(s):  
W. J. Lammers ◽  
H. R. Ahmad ◽  
K. Arafat
Keyword(s):  
High Resolution ◽  
Renal Pelvis ◽  
Refractory Period ◽  
Conduction Block ◽  
Temporal Variations ◽  
The Body ◽  
High Resolution Mapping ◽  
Resolution Mapping ◽  
Preceding Interval ◽  
And Behavior

In renal pelvis preparations isolated from the sheep, the location of the pacemaker and the pathway of conduction of the electrical impulse in the pelvis were analyzed in detail. An electrophysiological acquisition system was used allowing simultaneous recordings from 240 extracellular electrodes. Reconstruction of the spread of activity showed that the site of the pelvis pacemaker was, in virtually all cases, located at the pelvicalyceal border and never in the body of the pelvis or in the area of the pelviureteric junction. One single pacemaker was responsible for a particular spread of activation, and fusion of activity originating from two or more pacemakers did not place. Furthermore, spontaneous shifts of the pacemaker could occur from one site to another along the pelvicalyceal border. Conduction from the site of the current pacemaker to the pelviureteric junction and the ureter was slow, inhomogeneous, and contorted. Multiple instances of partial or total conduction block were seen at all levels in the pelvis and were not restricted to the pelviureteric junction. The occurrence of the conduction block did not seem to be related to the length of the preceding interval, implying that the refractory period did not play a major role in the genesis of intrapelvic conduction block. In conclusion, high-resolution mapping of the renal pelvis is possible and reveals location and behavior of the pacemaker and documents inhomogeneities in conduction and conduction block.

scholarly journals P246Validation of a novel high resolution mapping system for panoramic mapping of the left atrium: potential for mapping drivers in atrial fibrillation

EP Europace ◽  
2017 ◽  
Vol 19 (suppl_3) ◽  
pp. iii29-iii30
Author(s):  
S. Honarbakhsh ◽  
W. Ullah ◽  
E. Keating ◽  
G. Dhillon ◽  
M. Finlay ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
High Resolution ◽  
Left Atrium ◽  
High Resolution Mapping ◽  
Mapping System ◽  
Resolution Mapping

scholarly journals Future Solar System Missions

1990 ◽  
Vol 123 ◽  
pp. 297-306
Author(s):  
Geoffrey A. Briggs
Keyword(s):  
High Resolution ◽  
Solar System ◽  
Earth Orbit ◽  
Small Bodies ◽  
High Resolution Mapping ◽  
Saturnian System ◽  
Solar System Bodies ◽  
Resolution Mapping ◽  
Jovian System

After a decade long hiatus in launches beyond Earth orbit, NASA’s planetary exploration program is again moving forward, beginning with the Magellan launch to Venus in May 1989 and the Galileo launch to Jupiter in October 1989. These spacecraft will reach their targets in August 1990 and December 1995, respectively. Both are missions of longstanding priority, Magellan to provide the first global high resolution mapping of the cloud-shrouded Venus surface, Galileo to make comprehensive measurements of the Jovian system in follow-up to the 1979/1980 Voyager flybys.Beyond these two missions there are other already approved missions: the Mars Observer for launch in 1992, the Comet Rendezvous and Asteroid Flyby CRAF mission (Fig. 1) for launch in 1995, and the Cassini mission (Figs. 2 and 3) to Saturn and its moon Titan for launch in 1996. The very diversity of these five missions and their targets (Venus, the Jovian system, Mars, comet Kopff, asteroids Gaspra and Ida by Galileo, Hamburga by CRAF, and Maja by Cassini, and the Saturnian system, is indicative of the strategy being pursued in the program: one of deliberate breadth that seeks to explore all three main classes of solar system bodies (the terrestrial planets, the outer giants and their moons, and the primitive small bodies).

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