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Ultrahigh density atrio‐ventricular dual‐chamber mapping as a next generation tool for ablation of accessory pathways
Author(s) -
Mori Hitoshi,
Kawano Daisuke,
Sumitomo Naokata,
Muraji Shota,
Nabeshima Taisuke,
Tsutsui Kenta,
Ikeda Yoshifumi,
Iwanaga Shiro,
Nakano Shintaro,
Muramatsu Toshihiro,
Kobayashi Toshiki,
Kato Ritsushi,
Matsumoto Kazuo
Publication year - 2021
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.15070
Subject(s) - medicine , fluoroscopy , ablation , ventricle , catheter ablation , nuclear medicine , left atrium , accessory pathway , radiofrequency ablation , cardiology , radiology , atrial fibrillation
Detailed three‐dimensional (3D) mapping has been useful for effective radiofrequency catheter ablation. The Rhythmia system can create atrio‐ventricular dual‐chamber mapping, which reveals the atrial and ventricular potentials all at once in the same map. The aim of this study was to investigate the utility of mapping the atrium and ventricle simultaneously with a high‐density 3D mapping system for the ablation of accessory pathways (AP). Methods From July 2015 to August 2020, 111 patients underwent ablation of APs. Dual‐chamber maps were created in 50 patients (median age 15 [10–54], 32 male [64.0%]), while 61 patients underwent radiofrequency (RF) ablation with conventional single‐chamber 3D maps. The background characteristics and procedural details were compared between the dual‐chamber mapping group and the conventional single‐chamber mapping group. Results The number of RF applications (median [IQR]; 1.0 [1.0–3.0] vs. 3.0 [1.0–6.0], p = .0023), RF time (median [IQR], s; 9.2 [2.0–95.7] vs. 95.6 [4.1–248.7], p = .0107), and RF energy (median [IQR], J; 248.4 [58.7–3328.2] vs. 2867.6 [134.2–7728.4], p = .0115) were significantly lower in the dual‐chamber group. The fluoroscopy time (median [IQR], min; 19.9 [14.2–26.1] vs. 26.5 [17.7–43.4], p = .0025) and fluoroscopy dose (median [IQR], mGy; 52.5 [31.3–146.0] vs. 119.0 [43.7–213.5], p = .0249) were also significantly lower in the dual‐chamber than single‐chamber mapping group. Conclusion The dual‐chamber mapping was useful for ablating accessory pathways and reducing the number of RF applications, total RF energy, and radiation exposure as compared with traditional mapping techniques.