| Noncontact mapping-guided ablation of atrial flutter and enhanced-density mapping of the inferior vena caval-tricuspid annulus isthmus. | |
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MedLine Citation:
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PMID: 11817809 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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 a trial flutter and paced rhythms. Ablation was performed nonfluoroscopically based on reconstructed anatomy and conduction patterns. Noncontact mapping was compared and validated with conventional multielectrode technique. IVC-TA isthmus ablation was completed 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 nonfluoroscopic guidance of atrial flutter ablation and a comprehensive evaluation of the ablation results. |
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Authors:
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M A Schneider; G Ndrepepa; B Zrenner; M R Karch; S Schmieder; I Deisenhofer; J Schreieck; A Schömig; C Schmitt |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 24 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2001 Dec |
Date Detail:
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Created Date: 2002-01-30 Completed Date: 2002-07-12 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 1755-64 Citation Subset: IM |
Affiliation:
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Deutsches Herzzentrum and I. Medizinische Klinik, Technische Universität München, Munich, Germany. SchneiderM@DHM.mhn.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Atrial Flutter
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physiopathology,
surgery* Catheter Ablation Female Heart Conduction System / physiopathology Humans Imaging, Three-Dimensional Male Middle Aged Tricuspid Valve Vena Cava, Inferior |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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