Key result
A high-density mapping catheter with a steerable introducer support successfully detected a unidirectional epicardial connection that was abolished by radiofrequency delivery.
Case Report (n=1)
A high-density mapping catheter can detect unidirectional epicardial connections missed by conventional circular mapping catheters, facilitating successful ablation in persistent AF.
May support high-density mapping for epicardial connections in select cases; hypothesis-generating and requires prospective validation.
We report a case of recurring, persistent atrial fibrillation (AF) in a patient with a unidirectional epicardial connection (EC) between the right-sided pulmonary venous (PV) carina and the right atrium detected using a high-density mapping catheter with a steerable introducer support, but not a conventional circular mapping catheter. This unidirectional EC could be steadily abolished by a radiofrequency delivery. Finally, we were able to successfully achieve complete PV antrum isolation. Thereafter, he has remained well without any AF.
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Umemoto et al. (2022) conducted a case report in Recurring, persistent atrial fibrillation (n=1). High-density mapping catheter with a steerable introducer support and radiofrequency delivery vs. Conventional circular mapping catheter was evaluated on Detection of unidirectional epicardial connection and complete pulmonary vein antrum isolation. A high-density mapping catheter with a steerable introducer support successfully detected a unidirectional epicardial connection that was abolished by radiofrequency delivery.
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