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- Title
Low-Voltage Areas as Alternative Targets for the Ablation of un mappable Atrial Tachycardiain Patients Undergoing Atrial Fibrillation Ablation.
- Authors
Masaharu Masuda; Mitsutoshi Asai; Osamu Iida; Shin Okamoto; Takayuki Ishihara; Kiyonori Nanto; Takashi Kanda; Takuya Tsujimura; Yasuhiro Matsuda; Shota Okuno; Toshiaki Mano
- Abstract
Aims: Unmappable regular atrial tachycarrhythmias (ATs) occasionally develop during atrial fibrillation (AF) ablation, and are difficult to treat by conventional ablation. Recently, low-voltage areas (LVAs) have been reported to represent AT substrate. The purpose of this study was to elucidate the efficacy of LVA ablation for unmappable AT. Methods: This observational study included 32 consecutive patients who developed unmappable ATs during and after AF ablation. Unmappable AT was defined as AT lasting for >5 s, but that terminated or changed the activation sequence over too short a time to create a sufficient activation map. We used conventional ablation to target undetermined AT circuits estimated from activation timings of electrograms recorded on the placed electrode catheter, the response to entrainment mappings, and/or diastolic potentials during AT. Subsequently, in cases without successful elimination of unmappable ATs by conventional ablation, LVA (≤ 0.5mV) ablation was performed at the discretion of the operators. Results: Conventional ablation failed to eliminate at least one unmappable AT in 29 patients. Among them, LVA ablation was performed in 16 patients. LVA ablation eliminated all the unmappable ATs in 8 of 16patients. The LVA size did not differ between patients with and without the acute elimination of unmappable ATs (17±11 vs. 21±12 cm2, p=0.39), and AT/AF recurrence rates were comparable between the two groups (38% vs. 63%, p=0.62) during a mean follow-up period of 14±8 months. Conclusion: LVA ablation was efficacious to some extent for the elimination of unmappable ATs refractory to conventional ablation.
- Subjects
ATRIAL flutter; ATRIAL fibrillation; BODY surface mapping
- Publication
JAFIB: Journal of Atrial Fibrillation, 2020, Vol 13, Issue 2, p1
- ISSN
1941-6911
- Publication type
Article