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Atrial tachycardia circuits include low voltage area from index atrial fibrillation ablation relationship between RF ablation lesion and AT
Author(s) -
Kitamura Takeshi,
Takigawa Masateru,
Derval Nicolas,
Denis Arnaud,
Martin Ruairidh,
Vlachos Konstantinos,
Nakatani Yosuke,
Frontera Antonio,
Cheniti Ghassen,
Martin Claire A.,
Bourier Felix,
Lam Anna,
Duchateau Josselin,
Pambrun Thomas,
Sacher Frédéric,
Cochet Hubert,
Hocini Meleze,
Haïssaguerre Michel,
Jaïs Pierre
Publication year - 2020
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14576
Subject(s) - ablation , medicine , atrial fibrillation , catheter ablation , rf ablation , atrial tachycardia , cardiology , lesion , nuclear medicine , surgery
Background No study to date has used high‐density mapping to investigate the relationship between prior radiofrequency (RF) lesions for persistent atrial fibrillation (PsAF) ablation and subsequent atrial tachycardias (ATs). Methods From 41 consecutive patients who underwent AT ablation at a second procedure using an ultrahigh‐density mapping system, 22 patients (38 ATs) were included as they also had complete maps with a multipolar catheter and three‐dimensional (3D) mapping system at the time of the first PsAF ablation procedure. We, therefore, compared voltage maps from the first AF ablation procedure to those from the subsequent AT ablation procedure, as well as the lesion sets used for AF ablation vs the activation patterns in AT during the second procedure. Results In the 38 ATs, 211 of 285 analyzed atrial areas displayed low voltage area (LVA) (74%). Eighteen percent (38/211) existed before the index ablation for AF while 82% (173/211) were newly identified as LVA during the second procedure. Ninety‐nine percent (172/173) of the newly developed LVA colocalized with RF lesions delivered for PsAF. Of the 38 ATs, 89.5% (34/38) AT circuits were associated with newly developed LVA due to RF lesions whilst 10.5% (4/38) AT circuits were associated with pre‐existing LVA observed at the index procedure. No AT circuit was completely independent from index RF lesions in this series. Conclusions Analysis of detailed 3D electroanatomical mapping demonstrates that most ATs after PsAF ablation are involving LVAs due to index RF lesions.