Noncontact mapping-guided ablation of atrial flutter and enhanced-density mapping of the inferior vena caval-tricuspid annulus isthmus

Michael A.E. Schneider, Gjin Ndrepepa, Bernhard Zrenner, Martin R. Karch, Sebastian Schmieder, Isabel Deisenhofer, Jürgen Schreieck, Albert Schömig, Claus Schmitt

Publikation: Beitrag in FachzeitschriftArtikelBegutachtung

20 Zitate (Scopus)

Abstract

Three-dimensional visualization of cardiac activation has become important in providing further insights into pathophysiological mechanisms of arrhythmias and to increase the efficacy of catheter ablation. The noncontact mapping enables a single beat analysis in a reconstructed geometry of the cardiac chamber. The aim of the study was to describe three-dimensional activation patterns and inferior vena caval-tricuspid annulus (IVC-TA) isthmus conduction characteristics in patients with atrial flutter and the noncontact guidance of the radiofrequency ablation of this arrhythmia. In 34 patients with atrial flutter, the noncontact probe was deployed in the RA. The global three-dimensional activation and the isthmus conduction (enhanced density mapping) were delineated during ongoing atrial flutter and paced rhythms. Ablation was performed non-fluoroscopically based on reconstructed anatomy and conduction patterns. Noncontact mapping was compared and validated with conventional multielectrode technique. IVC-TA isthmus ablation was completedq successfully in 33 (97%) of 34 patients. In one patient a lower loop reentry around the inferior vena cava was depicted as a mechanism of atrial flutter. In another patient with positive flutter waves in inferior leads, an activation pattern typical of counterclockwise flutter was demonstrated in propagation maps. During a follow-up of 15.9 ± 5.9 months, two atrial flutter recurrences occurred (5.8%). A gap of the resumed conduction through the IVC-TA isthmus was delineated as a mechanism of recurrence and ablated with one and three radiofrequency applications. Noncontact mapping allows construction of the global activation patterns in typical and atypical atrial flutter. It enables the non fluoroscopic guidance of atrial flutter ablation and a comprehensive evaluation of the ablation results.

OriginalspracheEnglisch
Seiten (von - bis)1755-1764
Seitenumfang10
FachzeitschriftPacing and Clinical Electrophysiology
Jahrgang24
Ausgabenummer12
DOIs
PublikationsstatusVeröffentlicht - 2001

Fingerprint

Untersuchen Sie die Forschungsthemen von „Noncontact mapping-guided ablation of atrial flutter and enhanced-density mapping of the inferior vena caval-tricuspid annulus isthmus“. Zusammen bilden sie einen einzigartigen Fingerprint.

Dieses zitieren