Abnormal Atrial Potentials Recorded During Sinus Rhythm or Pacing Represent Substrates for Reentrant Atrial Tachycardia.

atrial tachycardia fragmented potential high-resolution mapping localized reentry macro-reentry

Journal

Circulation. Arrhythmia and electrophysiology
ISSN: 1941-3084
Titre abrégé: Circ Arrhythm Electrophysiol
Pays: United States
ID NLM: 101474365

Informations de publication

Date de publication:
Oct 2023
Historique:
medline: 23 10 2023
pubmed: 20 9 2023
entrez: 20 9 2023
Statut: ppublish

Résumé

Abnormal atrial potentials (AAPs) recorded during sinus rhythm/atrial pacing may indicate areas of slow conduction capable of supporting reentrant atrial tachycardia (AT). Therefore, we sought to examine the relationship between AAPs and AT circuits. One hundred twenty-three reentrant ATs in 104 patients were analyzed. AAPs, consisting of fragmented potentials and split potentials, were assessed using the Rhythmia LUMIPOINT algorithm. There was 93±13% overlap between areas with AAPs during sinus rhythm/atrial pacing and areas of slow conduction along the reentry circuit during AT. The cumulative area of AAPs was smaller in patients with localized-reentrant ATs compared with anatomic macro-reentrant ATs (20.0 [14.6-30.5] versus 28.9 [21.8-35.6] cm AAPs recorded during sinus rhythm/atrial pacing are associated with areas of slow conduction during reentrant AT. The burden and distribution of AAPs may provide actionable insights into AT circuit features, including in cases in which ATs are difficult to map.

Sections du résumé

BACKGROUND BACKGROUND
Abnormal atrial potentials (AAPs) recorded during sinus rhythm/atrial pacing may indicate areas of slow conduction capable of supporting reentrant atrial tachycardia (AT). Therefore, we sought to examine the relationship between AAPs and AT circuits.
METHODS METHODS
One hundred twenty-three reentrant ATs in 104 patients were analyzed. AAPs, consisting of fragmented potentials and split potentials, were assessed using the Rhythmia LUMIPOINT algorithm.
RESULTS RESULTS
There was 93±13% overlap between areas with AAPs during sinus rhythm/atrial pacing and areas of slow conduction along the reentry circuit during AT. The cumulative area of AAPs was smaller in patients with localized-reentrant ATs compared with anatomic macro-reentrant ATs (20.0 [14.6-30.5] versus 28.9 [21.8-35.6] cm
CONCLUSIONS CONCLUSIONS
AAPs recorded during sinus rhythm/atrial pacing are associated with areas of slow conduction during reentrant AT. The burden and distribution of AAPs may provide actionable insights into AT circuit features, including in cases in which ATs are difficult to map.

Identifiants

pubmed: 37728002
doi: 10.1161/CIRCEP.123.012241
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e012241

Auteurs

Yosuke Nakatani (Y)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

F Daniel Ramirez (FD)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).
Division of Cardiology, University of Ottawa Heart Institute, Canada (F.D.R.).
School of Epidemiology and Public Health, University of Ottawa, Canada (F.D.R.).

Masateru Takigawa (M)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Takashi Nakashima (T)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Clémentine André (C)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Cyril Goujeau (C)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Philipp Krisai (P)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Takamitsu Takagi (T)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Tsukasa Kamakura (T)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Konstantinos Vlachos (K)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Aline Carapezzi (A)

Boston Scientific, France (A.C.).

Ghassen Cheniti (G)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Romain Tixier (R)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Nicolas Welte (N)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Remi Chauvel (R)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Josselin Duchateau (J)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Thomas Pambrun (T)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Nicolas Derval (N)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Frédéric Sacher (F)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Meleze Hocini (M)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Michel Haïssaguerre (M)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

Pierre Jaïs (P)

Department of Cardiac Pacing and Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre, P.J.).
IHU LIRYC - CHU Bordeaux, France (Y.N., F.D.R., M.T., T.N., C.A., C.G., P.K., T.T., T.K., V.K., G.C., R.T., N.W., R.C., J.D., T.P., N.D., F.S., M. Hocini, M. Haïssaguerre. P.J.).

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