What is the clinical evidence from this study?

Study design: Observational. Population: Biatrial tachycardia (n=8). Intervention: Catheter ablation guided by ultrahigh-resolution mapping. Primary outcome: Successful termination of biatrial tachycardia.

What does this research mean for the field?

Catheter ablation guided by ultrahigh-resolution mapping successfully terminates the majority of single-loop macroreentrant biatrial tachycardias, which manifest in three distinct circuit types primarily driven by prior electrical obstacles on the anteroseptal left atrium. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To identify the electrophysiological characteristics and precise anatomical circuits of single-loop macroreentrant biatrial tachycardia using ultrahigh-resolution electroanatomical mapping.

February 1, 2018Circulation Arrhythmia and ElectrophysiologyOpen Access

Characteristics of Single-Loop Macroreentrant Biatrial Tachycardia Diagnosed by Ultrahigh-Resolution Mapping System

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Key result

Catheter ablation guided by ultrahigh-resolution mapping successfully terminated 8 of 9 (88.9%) single-loop macroreentrant biatrial tachycardias across 3 distinct circuit types.

Population

8 patients with 9 biatrial tachycardias identified from a cohort of 336 consecutive patients undergoing…

Design

Cohort

Authors

ΤKΤakeshi KitamuraHiroshima University RMRuairidh MartinFreeman Hospital ADArnaud DenisElectrophysiology

Discussion

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Implication

May support ultrahigh-resolution mapping-guided ablation for rare biatrial tachycardias; hypothesis-generating in small observational cohort.

Key Points

To identify the electrophysiological characteristics and precise anatomical circuits of single-loop macroreentrant biatrial tachycardia using ultrahigh-resolution electroanatomical mapping.
Analyzed 8 patients (median age 59.5 years) with 9 biatrial tachycardias identified from 336 consecutive patients undergoing catheter ablation across 2 institutions.
Performed automatic ultrahigh-resolution mapping of both atria (median 12,561 left atrial points and 8,814 right atrial points) during tachycardia (median cycle length 334 ms).
Classified 9 single-loop biatrial tachycardias into three distinct circuit types: perimitral and peritricuspid (n=3), right atrial septum and perimitral (n=3), and left/right atrial septal only (n=3).
Catheter ablation successfully terminated 8 of the 9 biatrial tachycardias (88.9%), with all patients displaying an electrical obstacle on the anteroseptal left atrium predominantly caused by prior ablation lesions.

Study Design

Type

Observational (n=8)

Multicenter

Yes

Structured PICO

Population

8 patients (median age 59.5 years) with 9 biatrial tachycardias (BiATs) identified from a cohort of 336 consecutive patients undergoing atrial tachycardia catheter ablation. 7 had prior persistent AF ablation, 1 had prior atrial septal patch closure.

Intervention

Catheter ablation guided by an automatic ultrahigh-resolution mapping system

Outcome

Characteristics and precise circuits of single-loop macroreentrant BiATs, and termination success rate

Ultrahigh-resolution mapping can identify distinct circuits of rare biatrial tachycardias, which are often related to prior anteroseptal left atrium ablation and can be successfully treated with targeted catheter ablation.

Cite This Study

Kitamura et al. (2018) conducted an observational in Biatrial tachycardia (n=8). Catheter ablation guided by ultrahigh-resolution mapping was evaluated on Successful termination of biatrial tachycardia. Catheter ablation guided by ultrahigh-resolution mapping successfully terminated 8 of 9 (88.9%) single-loop macroreentrant biatrial tachycardias across 3 distinct circuit types.

synapsesocial.com/papers/6a1539ff5347fbb1739f6f6b https://doi.org/10.1161/circep.117.005558

Topics

AF ablation outcomes

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Implication

May support ultrahigh-resolution mapping-guided ablation for rare biatrial tachycardias; hypothesis-generating in small observational cohort.

Characteristics of Single-Loop Macroreentrant Biatrial Tachycardia Diagnosed by Ultrahigh-Resolution Mapping System

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Characteristics of Single-Loop Macroreentrant Biatrial Tachycardia Diagnosed by Ultrahigh-Resolution Mapping System

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

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