Abstract 14374: The Atrium Conduction Mappings Using Omnipolar Technology for Detecting Epicardial Connection in Patients With Atrial Fibrillation

• Published in: Circulation (New York, N.Y.) N.Y.), 2023-11, Vol.148 (Suppl_1)
• Main Authors: Kogame, Takehiro, Mine, Takanao, Fukuhara, Eiji, Sugitani, Miho, Ishihara, Masaharu
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.148.suppl_1.14374

Abstract only Background: Epicardial connection (Epi-connection) between the right atrium (RA) and right pulmonary vein (RPV) has been known to complicate pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). Meanwhile, the omnipolar voltage detected using EnSite™ Omnipolar Technology (OT) has been reported to facilitate the recognition of wavefront direction and see every signal in 360 degrees. Purpose: We investigated whether epicardial RA-RPV connection can be evaluated with OT mapping before PVI. Methods: We prospectively studied 113 consecutive patients (74 males, age 71±10 years, 68 paroxysmal AF) who underwent initial pulmonary vein isolation (PVI) for AF. The RA-RPV connections before PVI were assessed using OT mappings during right atrial pacing. True Epi-connections were defined as cases that required additional ablation medial to the PV more than 1 cm from the ablation line after the right PVI. Results: RA-RPV connections before PVI were detected in 7 out of 113 patients (6.2%). True Epi-connections were confirmed in 7 out of 113 patients (6.2%, 6 patients with carina and 1 with right superior PV) and were not related to any other clinical data, blood samples, or echocardiographic findings. Only 5 out of 7 patients with RA-RPV connections before PVI showed True Epi-connections (Figure). Conclusion: The prevalence of Epi-connections is not high, however, the conduction mapping using OT could be useful for detecting Epi-connection (especially non-carina Epi-connection) before PVI.