Timing of critical isthmus from end of P wave and usefulness of activation mapping with window of interest from end to end of P wave in reentrant atrial tachycardia.

Activation mapping Atrial tachycardia Catheter ablation Isthmus Window of interest

Journal

Heart and vessels

ISSN: 1615-2573

Titre abrégé: Heart Vessels

Pays: Japan

ID NLM: 8511258

Informations de publication

Date de publication:
28 Nov 2023

Historique:

received: 26 06 2023

accepted: 01 11 2023

medline: 28 11 2023

pubmed: 28 11 2023

entrez: 28 11 2023

Statut: aheadofprint

Résumé

In activation mapping of reentrant atrial tachycardia (AT), there was no reference for window of interest (WOI). We examined the timing of a successful termination site from end of the P wave and attempted to determine whether the critical isthmus can be identified using activation mapping when WOI was set as end to end of the P wave. Forty patients with 54 reentrant AT who underwent 3D electroanatomic mapping and radiofrequency catheter ablation were evaluated retrospectively. The critical isthmus was defined as a successful termination site. We evaluate critical isthmus timing from end of the P wave and percentage of critical isthmus timing from end of the P wave to tachycardia cycle length. In 54 reentrant AT, Macro-reentry was identified in 46 (85.2%) and micro-reentry was identified in eight (14.8%). The timing of the critical isthmus site from end of the P wave was - 4.0 ± 31.1 ms (Macro-reentry vs. Micro-reentry; - 8.9 ± 29.4 ms vs. 24.0 ± 26.7 ms; P = 0.005). The percentage of critical isthmus timing from end of the P wave/tachycardia cycle length was - 1.4 ± 10.5% (Macro-reentry vs. Micro-reentry; - 3.1 ± 9.8% vs. 8.3 ± 9.3%, P = 0.004) The critical isthmus of reentrant AT is located within 10% backward and forward from end of the P wave to tachycardia cycle length. Setting the WOI from end to end of the P wave is useful for identification of the critical isthmus through activation mapping.

Identifiants

DOI: 10.1007/s00380-023-02335-9 PMID: 38015232

pubmed: 38015232

doi: 10.1007/s00380-023-02335-9

pii: 10.1007/s00380-023-02335-9

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Informations de copyright

Références

Patel AM, d’Avila A, Neuzil P, Kim SJ, Mela T, Singh JP, Ruskin JN, Reddy VY (2008) Atrial tachycardia after ablation of persistent atrial fibrillation: identification of the critical isthmus with a combination of multielectrode activation mapping and targeted entrainment mapping. Circ Arrhythm Electrophysiol 1(1):14–22

doi: 10.1161/CIRCEP.107.748160 pubmed: 19808389

Jais P, Shah DC, Haissaguerre M, Hocini M, Peng JT, Takahashi A, Garrigue S, Le Metayer P, Clementy J (2000) Mapping and ablation of left atrial flutters. Circulation 101(25):2928–2934

doi: 10.1161/01.CIR.101.25.2928 pubmed: 10869265

Ouyang F, Ernst S, Vogtmann T, Goya M, Volkmer M, Schaumann A, Bansch D, Antz M, Kuck KH (2002) Characterization of reentrant circuits in left atrial macroreentrant tachycardia: critical isthmus block can prevent atrial tachycardia recurrence. Circulation 105(16):1934–1942

doi: 10.1161/01.CIR.0000015077.12680.2E pubmed: 11997280

Anter E, Duytschaever M, Shen C, Strisciuglio T, Leshem E, Contreras-Valdes FM, Waks JW, Zimetbaum PJ, Kumar K, Spector PS, Lee A, Gerstenfeld EP, Nakar E, Bar-Tal M, Buxton AE (2018) Activation mapping with integration of vector and velocity information improves the ability to identify the mechanism and location of complex scar-related atrial tachycardias. Circ Arrhythm Electrophysiol 11(8):e006536

doi: 10.1161/CIRCEP.118.006536 pubmed: 30354312

Mechulan A, Bun SS, Masse A, Peret A, Leong-Feng L, Pons F, Bouharaoua A, Dieuzaide P, Prevot S (2022) An improved window of interest for electroanatomical mapping of atrial tachycardia. J Interv Card Electrophysiol 63(1):29–37

doi: 10.1007/s10840-021-00940-0 pubmed: 33506319

De Ponti R, Verlato R, Bertaglia E, Del Greco M, Fusco A, Bottoni N, Drago F, Sciarra L, Ometto R, Mantovan R, Salerno-Uriarte JA (2007) Treatment of macro-re-entrant atrial tachycardia based on electroanatomic mapping: identification and ablation of the mid-diastolic isthmus. Europace 9(7):449–457

doi: 10.1093/europace/eum055 pubmed: 17478460

Rav-Acha M, Ng CY, Heist EK, Rozen G, Chalhoub F, Kostis WJ, Ruskin J, Mansour M (2016) A novel annotation technique during mapping to facilitate the termination of atrial tachycardia following ablation for atrial fibrillation. J Cardiovasc Electrophysiol 27(11):1274–1281

doi: 10.1111/jce.13063 pubmed: 27506179

Magnin-Poull I, De Chillou C, Miljoen H, Andronache M, Aliot E (2005) Mechanisms of right atrial tachycardia occurring late after surgical closure of atrial septal defects. J Cardiovasc Electrophysiol 16(7):681–687

doi: 10.1046/j.1540-8167.2005.30605.x pubmed: 16050822

Stevenson IH, Kistler PM, Spence SJ, Vohra JK, Sparks PB, Morton JB, Kalman JM (2005) Scar-related right atrial macroreentrant tachycardia in patients without prior atrial surgery: electroanatomic characterization and ablation outcome. Heart Rhythm 2(6):594–601

doi: 10.1016/j.hrthm.2005.02.1038 pubmed: 15922265

Brunckhorst CB, Delacretaz E, Soejima K, Maisel WH, Friedman PL, Stevenson WG (2004) Identification of the ventricular tachycardia isthmus after infarction by pace mapping. Circulation 110(6):652–659

doi: 10.1161/01.CIR.0000138107.11518.AF pubmed: 15289385

Stevenson WG, Sager PT, Natterson PD, Saxon LA, Middlekauff HR, Wiener I (1995) Relation of pace mapping QRS configuration and conduction delay to ventricular tachycardia reentry circuits in human infarct scars. J Am Coll Cardiol 26(2):481–488

doi: 10.1016/0735-1097(95)80026-D pubmed: 7608454

Bun SS, Latcu DG, Marchlinski F, Saoudi N (2015) Atrial flutter: more than just one of a kind. Eur Heart J 36(35):2356–2363

doi: 10.1093/eurheartj/ehv118 pubmed: 25838435

Takigawa M, Martin CA, Derval N, Denis A, Vlachos K, Kitamura T, Frontera A, Martin R, Cheniti G, Lam A, Bourier F, Thompson N, Wolf M, Massoulie G, Escande W, Andre C, Zeng LJ, Nakatani Y, Roux JR, Duchateau J, Pambrun T, Sacher F, Cochet H, Hocini M, Haissaguerre M, Jais P (2019) Insights from atrial surface activation throughout atrial tachycardia cycle length: a new mapping tool. Heart Rhythm 16(11):1652–1660

doi: 10.1016/j.hrthm.2019.04.029 pubmed: 31004777