Atrial Fibrillation Global Changes after Pulmonary Vein and Posterior Wall Isolation: A Charge Density Mapping Study

Figures

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  Figure 1. Baseline charge density map (Patient 9). Charge density map with theAcQMap catheter. Each color point on the map corresponds to the color-matched legend on the left. (A) Atrial fibrillation cycle length (AFCL) map: left side, anterior-posterior view; right side, posterior-anterior view. An area of a short AFCL in the anterior wall (in red). The AFCL is higher in the posterior and roof regions. Color bar describes AFCL in ms. (B) LIA map: left side, anterior-posterior view; right side, posterior-anterior view. Higher LIA number in the anterior and posterior regions. Color bar describes LIA in LIA/s. (C) LRA map: left side, anterior-posterior view; right side, posterior-anterior view. Higher LRA number in the anterior and posterior regions. Color bar describes LRA in LRA/s. (D) FCA map: left side, anterior-posterior view; right side, posterior-anterior view. Higher FCA number in the anterior and posterior regions. Color bar describes FCA in FCA/s. FCA: focal centrifugal activation; LIA: localized irregular activation; LRA: localized rotational activation.

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  Figure 2. Charge density map after pulmonary vein isolation (Patient 9). Charge density map with the AcQmapTM catheter. Each color point on the map corresponds to the color-matched legend on the left. (A) Atrial fibrillation cycle length (AFCL) map: left side, anterior-posterior view; right side, posterior-anterior view. When compared with baseline, the AFCL is higher in the posterior region; there is no area of a short AFCL in the anterior region. Color bar describes AFCL in ms. (B) LIA map: left side, anterior-posterior view; right side, posterior-anterior view. Higher LIA number in the anterior and posterior regions. Color bar describes LIA in LIA/s. (C) LRA map: left side, anterior-posterior view; right side, posterior-anterior view. Higher LRA number in the anterior and posterior regions. Color bar describes LRA in LRA/s. (D) FCA map: left side, anterior-posterior view; right side, posterior-anterior view. Higher FCA number in the anterior and posterior regions. Color bar describes FCA in FCA/s. FCA: focal centrifugal activation; LIA: localized irregular activation; LRA: localized rotational activation.

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  Figure 3. Charge density map after posterior wall isolation (Patient 9). Charge density map with the AcQmapTM catheter after pulmonary vein isolation (PVI) + left atrial posterior wall isolation (LAPWI). Each color point on the map corresponds to the color-matched legend on the left. (A) Atrial fibrillation cycle length (AFCL) map: left side, anterior-posterior view; right side, posterior-anterior view. When compared with the baseline and post-PVI maps, the AFCL is higher, especially in the roof and posterior regions. Color bar describes AFCL in ms. (B) LIA map: left side, anterior-posterior view; right side, posterior-anterior view. After PVI + LAPWI, there is a significant reduction in LIA in the inferior region. Color bar describes LIA in LIA/s. (C) LRA map: left side, anterior-posterior view; right side, posterior-anterior view. After PVI + LAPWI, there is a significant reduction in LRA in the inferior region. Color bar describes LRA in LRA/s. (D) FCA map: left side, anterior-posterior view; right side, posterior-anterior view. Higher FCA number in the anterior and posterior regions with no significant change after PVI + LAPWI. Color bar describes FCA in FCA/s. FCA: focal centrifugal…

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  Figure 4. Regional analysis of abnormal activation patterns in charge density mapping. Each color box in the graph corresponds to the color-matched region (legend on the right). (A) LIA absolute number by region and procedural step, namely, baseline, after pulmonary vein isolation (PVI) and after left atrial posterior wall isolation (LAPWI). (B) LRA absolute number by region and procedural step, namely, baseline, after PVI and after LAPWI. (C) FCA absolute number by region and procedural step, namely, baseline, after pulmonary vein isolation (PVI) and after LAPWI. FCA: focal centrifugal activation; LIA: localized irregular activation; LRA: localized rotational activation. The midline of each boxplot is the median, with the upper and lower limits of the box being the 3rd and 1st quartiles (75th and 25th percentiles), respectively. By default, the whiskers will extend up to 1.5 times the interquartile range from the top (bottom) of the box to the furthest datum within that distance.