Clinical impact of high-density mapping on the acute and long term outcome of atypical atrial flutter ablations.

Atypical atrial flutter Electro-anatomical map High-density mapping

Journal

Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
ISSN: 1572-8595
Titre abrégé: J Interv Card Electrophysiol
Pays: Netherlands
ID NLM: 9708966

Informations de publication

Date de publication:
17 Jan 2022
Historique:
received: 02 09 2021
accepted: 05 01 2022
entrez: 17 1 2022
pubmed: 18 1 2022
medline: 18 1 2022
Statut: aheadofprint

Résumé

We evaluated the clinical impact of the high-density (HD) mapping compared with the standard low-density (LD) ablation catheter mapping technique in the treatment of AFLs. We retrospectively evaluated short and long outcomes of patients approached with an HD and a LD electro-anatomical strategy for atypical AFLs. Eighty-seven patients were included. Patients were almost male (60%), relatively old (65 ± 8 years), with a moderate CHA2DS2Vasc score (2.3 ± 1.3), a preserved ejection fraction (58 ± 6), and moderate atrial dilatation (44 ± 7 mm). Baseline clinical characteristics were comparable between groups (p = NS). Among AFLs, 10 (11%) were located in the right and 78 (89%) in the left atrium, including 22 (28%) roof dependent and 37 (47%) mitral dependent (p = NS). Sinus rhythm restoration during ablation was more frequently observed in the HD group (79% vs 56%, p = 0.037), without differences in mapping time, procedural time, and radiological dose (p = NS). Overall AFL/AT/AF recurrence rate at 1, 2, and 3 years was lower in the HD group (14% vs 37% p = 0.02, 14% vs 48% p = 0.002 and 14% vs 50% p < 0.001, respectively) with a time-dependent trend only in the LD group (37% vs 48% vs 50% at 1, 2, and 3 years respectively, p = 0.059). HD mapping (OR 0.17; 95% CI 0.04-0.66) and younger age (OR 1.09; 95% CI 1.01-1.19) resulted independent predictors of overall arrhythmias at follow-up. Short- and long-term outcomes of atypical AFL ablation were better in the case of HD mapping, which resulted independent predictor of arrhythmia recurrences.

Identifiants

DOI: 10.1007/s10840-022-01121-3 PMID: 35037145
pubmed: 35037145
doi: 10.1007/s10840-022-01121-3
pii: 10.1007/s10840-022-01121-3
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Références

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Auteurs

Andrea Di Cori (A)

Second Division of Cardiology, Cardiac-Toracic and Vascular Department, AOUP, New Santa Chiara Hospital, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy. a.dicori@gmail.com.

Lorenzo Mazzocchetti (L)

Second Division of Cardiology, Cardiac-Toracic and Vascular Department, AOUP, New Santa Chiara Hospital, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Matteo Parollo (M)

Second Division of Cardiology, Cardiac-Toracic and Vascular Department, AOUP, New Santa Chiara Hospital, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Mario Giannotti (M)

Second Division of Cardiology, Cardiac-Toracic and Vascular Department, AOUP, New Santa Chiara Hospital, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Antonio Canu (A)

Second Division of Cardiology, Cardiac-Toracic and Vascular Department, AOUP, New Santa Chiara Hospital, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Valentina Barletta (V)

Second Division of Cardiology, Cardiac-Toracic and Vascular Department, AOUP, New Santa Chiara Hospital, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Salvatore Della Volpe (SD)

Second Division of Cardiology, Cardiac-Toracic and Vascular Department, AOUP, New Santa Chiara Hospital, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Raffaele De Lucia (R)

Second Division of Cardiology, Cardiac-Toracic and Vascular Department, AOUP, New Santa Chiara Hospital, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Stefano Viani (S)

Second Division of Cardiology, Cardiac-Toracic and Vascular Department, AOUP, New Santa Chiara Hospital, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Luca Segreti (L)

Second Division of Cardiology, Cardiac-Toracic and Vascular Department, AOUP, New Santa Chiara Hospital, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Ezio Soldati (E)

Second Division of Cardiology, Cardiac-Toracic and Vascular Department, AOUP, New Santa Chiara Hospital, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Giulio Zucchelli (G)

Second Division of Cardiology, Cardiac-Toracic and Vascular Department, AOUP, New Santa Chiara Hospital, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Maria Grazia Bongiorni (MG)

Second Division of Cardiology, Cardiac-Toracic and Vascular Department, AOUP, New Santa Chiara Hospital, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Classifications MeSH