Key result
High-density mapping using the Rhythmia system identified an optimal ablation target that differed from the traditional mid-diastolic corridor in 8 of 26 (31%) intra-atrial re-entrant tachycardias.
Why the study?
To evaluate an ultrahigh mapping system's ability to identify the most convenient Rhythmia ablation target in intra-atrial re-entrant tachycardias based on the narrowest area to transect.
Does an ultrahigh mapping system identify ablation targets different from the mid-diastolic isthmus in patients with intra-atrial re-entrant tachycardias?
Observational (n=24)
Does an ultrahigh mapping system identify ablation targets different from the mid-diastolic isthmus in patients with intra-atrial re-entrant tachycardias?
High-density mapping identifies optimal ablation targets outside the mid-diastolic corridor in about one-third of intra-atrial re-entrant tachycardias.
Answers are grounded in this paper and cite their sources.
High-density mapping may identify non-traditional targets in IART; hypothesis-generating and should not yet change practice.
AIMS: We evaluated the ability of an ultrahigh mapping system to identify the most convenient Rhythmia ablation target (RAT) in intra-atrial re-entrant tachycardias (IART) in terms of the narrowest area to transect to interrupt the re-entry. METHODS: A total of 24 consecutive patients were enrolled with a total of 26 IARTs. The Rhythmia mapping system was used to identify the RAT in all IARTs. RESULTS: In 18 cases the RAT matched the mid-diastolic phase of the re-entry whereas in 8 cases the RAT differed. In these patients, the mid-diastolic tissue in the active circuit never represented the area with the slowest conduction velocity of the re-entry. The mean conduction velocity at the mid-diastolic site was significantly slower in the group of patients in which the RAT matched the mid-diastolic site (P = 0.0173) and that of the remaining circuit was significantly slower in the group in which the RAT did not match (P = 0.0068). The mean conduction velocity at the RAT was comparable between the two groups (P = 0.66). CONCLUSION: Identifying the RAT in challenging IARTs by means of high-density representation of the wavefront propagation of the tachycardia seems feasible and effective. In one-third of cases this approach identifies an area that differs from the mid-diastolic corridor.
No takes yet. Share an insight, caveat, or question.
Simone et al. (2019) conducted an observational in Intra-atrial re-entrant tachycardias (IART) (n=24). Rhythmia ultrahigh mapping system vs. Traditional mid-diastolic phase targeting was evaluated on Identification of the most convenient Rhythmia ablation target (RAT) in terms of the narrowest area to transect. High-density mapping using the Rhythmia system identified an optimal ablation target that differed from the traditional mid-diastolic corridor in 8 of 26 (31%) intra-atrial re-entrant tachycardias.
Synapse has enriched 10 related papers. Consider them for comparative context: