What question did this study set out to answer?

To determine whether two independent electrogram mapping techniques identify concordant rotational activation patterns at catheter ablation sites that terminate persistent atrial fibrillation.

February 10, 2017Journal of Cardiovascular ElectrophysiologyOpen Access

Two Independent Mapping Techniques Identify Rotational Activity Patterns at Sites of Local Termination During Persistent Atrial Fibrillation

Q: What are the key findings of this study?

An independent mapping technique identified stable rotational activation sources in 100% (12/12) of cases, showing spatial concordance with FIRM mapping (P<0.05) at sites where ablation terminated AF.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Persistent atrial fibrillation (n=12). Intervention: Technique 2 (Kuklik, Schotten et al. phase maps) vs. Technique 1 (activation/phase mapping, FIRM). Primary outcome: Identification of a source and spatial concordance (p=<0.05).

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Key result

Independent mapping detects stable rotational sources in ~100% of cases, matching FIRM at AF termination sites.

P<0.05
n=12

Why the study?

Do two independent mapping techniques show spatial concordance in identifying rotational activation patterns at sites of local termination during persistent AF?

Population

12 patients with persistent atrial fibrillation in whom ablation terminated persistent AF before pulmonary…

Comparison

Mapping with technique 2 vs Mapping with technique 1

Design

Cohort

Authors

MAMahmood AlhusseiniCardiovascular Institute of the South DVDavid VidmarTempus Labs (United States)GMG. MecklerUC Irvine Health

Discussion

Member takes

Implication

Supports concordant mapping of rotational sources in persistent AF; leaves open clinical utility pending randomized validation.

Key Points

To determine whether two independent electrogram mapping techniques identify concordant rotational activation patterns at catheter ablation sites that terminate persistent atrial fibrillation.
Evaluated 12 patients with persistent atrial fibrillation (mean age 61.2 ± 10.8 years, 4 female) mapped using 64-pole basket catheters.
Identified rotational activation patterns using technique 1 (activation/phase mapping, FIRM) for ≥50% of a 4-second window, followed by targeted ablation prior to pulmonary vein isolation.
Re-analyzed patient unipolar electrograms using an independent phase mapping algorithm (technique 2) to determine spatial and rotational concordance.
Targeted ablation at rotational activation sites terminated persistent atrial fibrillation to sinus rhythm in 10 patients and atrial tachycardia in 2 patients.
Technique 2 identified a rotational source in 12 of 12 patients (100%), exhibiting spatial concordance with technique 1 across all cases (P < 0.05) alongside matching rotational characteristics.

Study Design

Type

Observational (n=12)

Structured PICO

Do two independent mapping techniques show spatial concordance in identifying rotational activation patterns at sites of local termination during persistent AF?

Population

12 patients with persistent atrial fibrillation (mean age 61.2 ± 10.8 years, 4 female) in whom ablation terminated persistent AF before pulmonary vein isolation

Intervention

Mapping with technique 2 (phase maps of activation by Kuklik, Schotten et al.)

Comparator

Mapping with technique 1 (activation/phase mapping, FIRM)

Outcome

Spatial concordance and rotational characteristics between the two mapping techniques at sites where ablation terminated AFsurrogate

Main Result

Absolute Event Rate: 100% vs 100%

p-value: p=<0.05

Two independent mapping techniques showed spatial concordance in identifying stable rotational activation patterns at sites where ablation terminated persistent AF.

Cite This Study

Alhusseini et al. (2017) conducted an observational in Persistent atrial fibrillation (n=12). Technique 2 (Kuklik, Schotten et al. phase maps) vs. Technique 1 (activation/phase mapping, FIRM) was evaluated on Identification of a source and spatial concordance (p=<0.05). An independent mapping technique identified stable rotational activation sources in 100% (12/12) of cases, showing spatial concordance with FIRM mapping (P<0.05) at sites where ablation terminated AF.

synapsesocial.com/papers/6a0d2909d7cdc72b8665669a https://doi.org/10.1111/jce.13177

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes Anticoagulation in AF

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Two Independent Mapping Techniques Identify Rotational Activity Patterns at Sites of Local Termination During Persistent Atrial Fibrillation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Two Independent Mapping Techniques Identify Rotational Activity Patterns at Sites of Local Termination During Persistent Atrial Fibrillation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

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