Deductive mapping and postpacing interval mapping are useful techniques for identifying the sources of complex, multiple atrial tachycardias following extensive ablation for persistent atrial fibrillation.
May aid mapping of complex post-persistent AF tachycardias; leaves open need for prospective validation.
A combination of pulmonary vein isolation (PV), electrogram-based ablation, and linear lesions have been demonstrated to result in medium-term freedom from atrial fibrillation (AF) in the majority of patients with persistent AF in several studies. Such an extensive ablation is associated with a high incidence of postablation atrial tachycardia (AT), which is often complex and multiple. Deductive mapping strategy, 1,2 which consists of activation mapping and entrainment mapping, can identify the mechanism and/or source of the postablation AT rapidly and accurately. However, careful mapping and close observation to identify subtle changes between the ATs are necessary. Postpacing interval (PPI) mapping is a useful technique, with some limitation for focal AT. It also demonstrated the utility of PPI mapping in the precise diagnosis of the sources of focal ATs.
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Miyazaki et al. (2011) studied this question.
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