Three-Dimensional Electroanatomic Mapping Systems in Catheter Ablation of Atrial Fibrillation

Lo, Li Wei; Chen, Shih Ann

doi:10.1253/circj.cj-09-0676

Cited by 20 publications

(8 citation statements)

References 42 publications

(58 reference statements)

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“…Three-dimensional electroanatomic mapping has been used to study the functional properties of AVN and different arrhythmias, which might help to study functional and morphological change of AVN with aging in the future. 21, 22 A higher number of RF applications were needed to achieve However, those studies investigated age-related differences by the cut-off point of 65 years, which might not be applicable to the patients aged 20-40 years in the present study.…”

Section: Paradoxical Changes In Av Nodal Electrophysiological Charactmentioning

confidence: 89%

Paradoxical Aging Changes of the Atrioventricular Nodal Properties in Patients With Atrioventricular Nodal Re-Entrant Tachycardia

Tseng

Tsai

et al. 2011

Circ J

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Background: This study aimed to investigate the impact of aging on electrophysiological characteristics in patients with atrioventricular nodal re-entrant tachycardia (AVNRT). Methods and Results:The 2,111 patients who underwent an electrophysiological study and radiofrequency (RF) catheter ablation of AVNRT were enrolled. The patients were divided into 4 groups according to age (group 1: <20 years; group 2: 20-39 years; group 3: 40-59 years; and group 4: ≥60 years). The gender distribution differed with age. The atrio-Hisian interval, and effective refractory periods (ERP) of the right atrium, ventricle, antegrade slow pathway, retrograde slow pathway and fast pathway, and tachycardia cycle length all increased with age. However, a paradoxical change in the fast pathway ERP was noted. The fast pathway ERP was significantly longer in group 2 than in other groups, and was associated with the largest tachycardia window. The response to catecholamines was similar between different age groups. Procedure time, radiation time, and complications did not differ. However, the number of RF impulses was higher in group 2 compared with other groups (7.6±9.3, P=0.04), which might imply a differing complexity during the ablation. Conclusions:Paradoxical aging changes of AVN electrophysiological characteristics were associated with a different atrioventricular nodal conduction property and the number of RF impulses. (Circ J 2011; 75: 1581 -1584

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Section: Paradoxical Changes In Av Nodal Electrophysiological Charactmentioning

confidence: 89%

Paradoxical Aging Changes of the Atrioventricular Nodal Properties in Patients With Atrioventricular Nodal Re-Entrant Tachycardia

Tseng

Tsai

et al. 2011

Circ J

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“…ability to pace and capture ablated tissue, and maneuvers to pace and detect gaps in linear lesions created by multipoint ablations (23). Yet, these assessments provide only limited information regarding the extent and physiological state of the lesion.…”

Section: Discussionmentioning

confidence: 99%

Use of endogenous NADH fluorescence for real-time in situ visualization of epicardial radiofrequency ablation lesions and gaps

Mercader

Swift

Sood

et al. 2012

American Journal of Physiology-Heart and Circulatory Physiology

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Mercader M, Swift L, Sood S, Asfour H, Kay M, Sarvazyan N. Use of endogenous NADH fluorescence for real-time in situ visualization of epicardial radiofrequency ablation lesions and gaps. Am J Physiol Heart Circ Physiol 302: H2131-H2138, 2012. First published March 9, 2012; doi:10.1152/ajpheart.01141.2011.-Radiofrequency ablation (RFA) aims to produce lesions that interrupt reentrant circuits or block the spread of electrical activation from sites of abnormal activity. Today, there are limited means for real-time visualization of cardiac muscle tissue injury during RFA procedures. We hypothesized that the fluorescence of endogenous NADH could be used as a marker of cardiac muscle injury during epicardial RFA procedures. Studies were conducted in blood-free and blood-perfused hearts from healthy adult Sprague-Dawley rats and New Zealand rabbits. Radiofrequency was applied to the epicardial surface of the heart using a 4-mm standard blazer ablation catheter. A dual camera optical mapping system was used to monitor NADH fluorescence upon ultraviolet illumination of the epicardial surface and to record optical action potentials using the voltage-sensitive probe RH237. Epicardial lesions were seen as areas of low NADH fluorescence. The lesions appeared immediately after ablation and remained stable for several hours. Real-time monitoring of NADH fluorescence allowed visualization of viable tissue between the RFA lesions. Dual recordings of NADH and epicardial electrical activity linked the gaps between lesions to postablation reentries. We found that the fluorescence of endogenous NADH aids the visualization of injured epicardial tissue caused by RFA. This was true for both blood-free and blood-perfused preparations. Gaps between NADH-negative regions revealed unablated tissue, which may promote postablation reentry or provide pathways for the conduction of abnormal electrical activity. catheter ablation; arrhythmias; lesion; imaging; atrial fibrillation RADIOFREQUENCY ABLATION (RFA) is an effective therapy for treating atrial and ventricular rhythm disturbances (16). Nearly 100,000 RFA procedures are performed annually in the United States to treat cardiac arrhythmias (29). RFA targets the key elements of reentrant pathways and/or abnormal ectopic loci without damaging a significant amount of adjacent healthy myocardium and coronary vessels.RFA lesion size is not simply a function of delivered energy but depends on many factors, including the contact between the catheter tip and the tissue, the thickness of the myocardium, the amount of blood flow, and the presence of fat (16,33). Conventional electroanatomical mapping systems map mainly the location of the catheter tip but not the extent of tissue injury caused by ablation. Therefore, as of today, RFA ablation lesions are created with minimal information regarding the physiological condition of the affected tissue.Gaps of excitable tissue between ablation lesions are directly related to arrhythmia recurrences. Two main strategies have been proposed to reduce the inc...

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“…and Chen et al . The development of the 3‐dimensional (3D) electroanatomic mapping system has provided accurate visualization of the atrial anatomy and identification of atrial substrate properties for catheter ablation of AF . The characteristics of the substrate properties between vagal and sympathetic AF have not been previously elucidated.…”

Section: Introductionmentioning

confidence: 99%

Differences in the Atrial Electrophysiological Properties Between Vagal and Sympathetic Types of Atrial Fibrillation

Chiou

Lin

et al. 2013

Cardiovasc electrophysiol

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Three-Dimensional Electroanatomic Mapping Systems in Catheter Ablation of Atrial Fibrillation

Cited by 20 publications

References 42 publications

Paradoxical Aging Changes of the Atrioventricular Nodal Properties in Patients With Atrioventricular Nodal Re-Entrant Tachycardia

Paradoxical Aging Changes of the Atrioventricular Nodal Properties in Patients With Atrioventricular Nodal Re-Entrant Tachycardia

Use of endogenous NADH fluorescence for real-time in situ visualization of epicardial radiofrequency ablation lesions and gaps

Differences in the Atrial Electrophysiological Properties Between Vagal and Sympathetic Types of Atrial Fibrillation

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