New Approach for Atrioventricular Conduction Modulation by Ablation at a Distance From the Atrioventricular Node

Criado, José Luis Ibáñez; Ibáñez-Críado, Alicia; Barrio-López, Teresa; Brouzet, Thomas; Castellanos, Eduardo; Ortiz, Mercedes; Sánchez-Quiñones, Jessica; García-Fernández, Amaya; Ramos-Ruiz, Pablo; Heras, Santiago; Ferrer, Raquel Ajo; Ferrer, M. A. Galvany; Quiles, Juan; Sogorb-Garri, Francisco; Martı́nez, Juan Gabriel; Almendral, Jesús

doi:10.1161/circep.120.009550

Cited by 5 publications

(3 citation statements)

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“…We considered that the low-voltage areas on the edge of small and heterogenetic scars can form slow conduction zones and a reentrant isthmus, which can cause small reentry and micro reentry and result in the higher occurrence of FAT in patients with SS. Some novel ablation methods, such as isolation of the right atrial free wall and atrioventricular node modulation, were proven to be feasible in AT treatment, but these methods did not target the critical isthmus in the substrate of ATs [18,19]. In this research, all radiofrequency ablation was tailored according to specific AT mechanisms and substrates.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Ablation Outcomes of Atrial Tachycardia in Patients with Prior Cardiac Surgery vs. Spontaneous Scars: Where Are the Differences?

Wang

Liang

et al. 2022

JCM

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(1) Background: Atrial scars play an important role in atrial tachycardia (AT). They can not only be found in patients with prior cardiac surgery (PCS) but also in patients without PCS or significant structural heart disease, in which case the scar is called a spontaneous scar (SS). This study aims to compare the characteristics, mechanisms and ablation outcomes of AT in patients with PCS and SS. (2) Methods: We retrospectively reviewed electrophysiological and ablative characteristics of ATs in 46 patients with PCS and 18 patients with SS. (3) Results: There were averages of 1.52 and 2.33 ATs per patient in the PCS group and SS group, respectively (p < 0.01). Cavo-tricuspid isthmus dependent atrial flutter (CTI-AFL) was presented in most patients in both groups (93.50% vs. 77.80%, p = 0.17), whereas the SS group had a higher occurrence of scar-mediated reentrant AT (SMAT) and focal AT (FAT) compared with the PCS group (88.90% vs. 39.10%, p < 0.01; 22.2% vs. 2.2%, p < 0.05). There were no significant differences in acute success rate between the two groups, whereas patients with SS had lower long-term success rate (87.0% vs. 61.1%, p < 0.05) and higher occurrence of sinus node dysfunction (SND) (4.3% vs. 22.2%, p < 0.05). (4) Conclusions: CTI-AFL is common in both patients with PCS and SS, and routine CTI ablation is recommended. Compared with patients with PCS, patients with SS have more ATs, especially with higher occurrence of SMAT and FAT, and had a lower long-term success rate and higher incidence of SND.

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Section: Discussionmentioning

confidence: 99%

Characteristics and Ablation Outcomes of Atrial Tachycardia in Patients with Prior Cardiac Surgery vs. Spontaneous Scars: Where Are the Differences?

Wang

Liang

et al. 2022

JCM

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“…1 We observed that the mean distance between the atrial breakthrough and the His bundle electrogram was 0.62 cm but this was highly variable (0.36-1.4 cm). 2 It would be very interesting to know if, before achieving a complete block, a progressive decrease in heart rate (or an increase in atrioventricular block cycle length in those patients who were in sinus rhythm during the procedure) occurred. Likewise, to know if there was a progressive prolongation of the PR interval.…”

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confidence: 99%

Atrioventricular conduction modulation and ablation: Better at a distance from the node?

Criado¹,

Almendral

2023

Cardiovasc electrophysiol

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“…As your group has shown in a recent publication, atrioventricular (AV) node modulation using a retrograde pacing activation map is also an effective and safe method with benefits in terms of maintaining heart rate and reducing fluoroscopy times. 1 We have also gathered experience with His potential voltage map "Mont Blanc Approach" for His bundle stimulation. 2 We originally wanted to use this map for AV node isolation (AVNI), but the "His cloud" is the simplest solution as it is easily reproducible and does not require sinus rhythm, since the goal is to isolate the AV node.…”

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confidence: 99%

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Imnadze

Lemke

Sommer

2023

Cardiovasc electrophysiol

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New Approach for Atrioventricular Conduction Modulation by Ablation at a Distance From the Atrioventricular Node

Cited by 5 publications

References 5 publications

Characteristics and Ablation Outcomes of Atrial Tachycardia in Patients with Prior Cardiac Surgery vs. Spontaneous Scars: Where Are the Differences?

Characteristics and Ablation Outcomes of Atrial Tachycardia in Patients with Prior Cardiac Surgery vs. Spontaneous Scars: Where Are the Differences?

Atrioventricular conduction modulation and ablation: Better at a distance from the node?

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