Electroanatomic mapping using a specific parameter setting identified the mid-diastolically activated isthmus in 97.5% of MAT morphologies, achieving acute arrhythmia abolition in 92.4% of cases.
Observational (n=65)
Yes
Does electroanatomic mapping using a specific parameter setting effectively identify the mid-diastolic isthmus and guide ablation in patients with macro-re-entrant atrial tachycardia?
Electroanatomic mapping with a specific parameter setting is highly effective for identifying and guiding ablation of the mid-diastolic isthmus in macro-re-entrant atrial tachycardia, yielding high acute suppression and low recurrence.
AIMS: This multicentre prospective study evaluated the ability of electroanatomic mapping (EAM) using a specific parameter setting to identify clearly the mid-diastolically activated isthmus (MDAI) and guide ablation of macro-re-entrant atrial tachycardia (MAT). METHODS AND RESULTS: Consecutive patients with MAT, different from typical isthmus-dependent atrial flutter, were enrolled. EAM was performed using a specific setting of the window of interest, calculated to identify the MDAI and guide ablation of this area. Sixty-five patients exhibiting 81 MATs (mean cycle length 308 +/- 68 ms) were considered. Thirty-two (49.2%) had previous heart surgery. In 79 of 81 morphologies (97.5%), EAM reconstructed 95.9 +/- 4.3% of the tachycardia circuit and identified the MDAI; 23 of the 79 morphologies (29.1%) were double-loop re-entry. Mapping of two morphologies was incomplete due to MAT termination after catheter bumping. In 73 of 79 mapped morphologies (92.4%), abolition of the MAT was obtained by 13.2 +/- 12.4 applications. During the 14 +/- 4 month follow-up, MAT recurred in 4 of the successfully treated patients (6.8%). CONCLUSION: EAM using a specific parameter setting proved highly effective at identifying the MDAI in MAT, even in patients with previous surgery and multiple re-entrant loops. Ablation of the MDAI yielded acute arrhythmia suppression with low rate of recurrence during follow-up.
Ponti et al. (Thu,) conducted a observational in macro-re-entrant atrial tachycardia (MAT) (n=65). Electroanatomic mapping (EAM) to identify and ablate the mid-diastolically activated isthmus (MDAI) was evaluated on Abolition of MAT. Electroanatomic mapping using a specific parameter setting identified the mid-diastolically activated isthmus in 97.5% of MAT morphologies, achieving acute arrhythmia abolition in 92.4% of cases.