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Does the extent of left atrial arrhythmogenic substrate depend on the electroanatomical mapping technique: impact of pulmonary vein mapping catheter vs. ablation catheter
In persistent atrial fibrillation (AF), left atrial low-voltage areas and complex fractionated atrial electrograms (CFAEs) have been thoroughly discussed as critical substrate points for AF perpetuation. Thus, in patients undergoing pulmonary vein isolation, these sites are often considered addition...
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| Published in: | Europace (London, England) England), 2017-08, Vol.19 (8), p.1293-1301 |
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| container_title | Europace (London, England) |
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| creator | Huemer, Martin Qaiyumi, Daniel Attanasio, Philipp Parwani, Abdul Pieske, Burkert Blaschke, Florian Boldt, Leif-Hendrik Haverkamp, Wilhelm Wutzler, Alexander |
| description | In persistent atrial fibrillation (AF), left atrial low-voltage areas and complex fractionated atrial electrograms (CFAEs) have been thoroughly discussed as critical substrate points for AF perpetuation. Thus, in patients undergoing pulmonary vein isolation, these sites are often considered additional ablation targets. Currently, mapping techniques for these substrate indicators are still under discussion. The aim of this study was to evaluate the impact of different mapping catheters on the detection of low-voltage areas and CFAE.
Two bipolar voltage maps and two CFAE left atrial maps were obtained each in 30 patients undergoing catheter ablation of AF using the following two different catheters: A four-pole ablation catheter (MAP, mapping and ablation catheter) (electrode size: tip: 4 mm, band: 1 mm; inter-electrode spacing: 0.5-5-2 mm) and a 10-pole circular pulmonary vein mapping catheter (CMC) (electrode size: 1 mm; inter-electrode spacing: 7-7-7 mm). Successively, low-voltage and CFAE area sizes were then compared between the two catheters. Areas with a bipolar voltage of |
| doi_str_mv | 10.1093/europace/euw185 |
| format | article |
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Two bipolar voltage maps and two CFAE left atrial maps were obtained each in 30 patients undergoing catheter ablation of AF using the following two different catheters: A four-pole ablation catheter (MAP, mapping and ablation catheter) (electrode size: tip: 4 mm, band: 1 mm; inter-electrode spacing: 0.5-5-2 mm) and a 10-pole circular pulmonary vein mapping catheter (CMC) (electrode size: 1 mm; inter-electrode spacing: 7-7-7 mm). Successively, low-voltage and CFAE area sizes were then compared between the two catheters. Areas with a bipolar voltage of <0.5 mV were significantly smaller when obtained with the CMC compared with the MAP (8.9 ± 8.9 vs. 17.4 ± 11.7 cm², P < 0.001). This was also significantly different for a bipolar voltage of <0.2 mV (2.3 ± 4.6 vs. 6.2 ± 9.6 cm², P < 0.001). Complex fractionated atrial electrogram area sizes were significantly larger when obtained with the CMC compared with the MAP group (14.6 ± 10.9 vs. 19.4 ± 9.4 cm², P = 0.011).
Low-voltage and CFAE area size varies significantly between different mapping catheters. Mapping electrode settings have to be taken into consideration for the assessment of electroanatomical substrate of AF.</description><identifier>ISSN: 1099-5129</identifier><identifier>EISSN: 1532-2092</identifier><identifier>DOI: 10.1093/europace/euw185</identifier><identifier>PMID: 27738066</identifier><language>eng</language><publisher>England</publisher><subject>Action Potentials ; Aged ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - physiopathology ; Atrial Fibrillation - surgery ; Cardiac Catheterization - instrumentation ; Cardiac Catheters ; Catheter Ablation - instrumentation ; Electrophysiologic Techniques, Cardiac - instrumentation ; Equipment Design ; Female ; Heart Rate ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Pulmonary Veins - physiopathology ; Pulmonary Veins - surgery ; Reproducibility of Results ; Signal Processing, Computer-Assisted</subject><ispartof>Europace (London, England), 2017-08, Vol.19 (8), p.1293-1301</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c338t-48060cadcad78be929870705d3df563c7ed48d993f1b27c62576b56a929c74443</citedby><cites>FETCH-LOGICAL-c338t-48060cadcad78be929870705d3df563c7ed48d993f1b27c62576b56a929c74443</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27738066$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huemer, Martin</creatorcontrib><creatorcontrib>Qaiyumi, Daniel</creatorcontrib><creatorcontrib>Attanasio, Philipp</creatorcontrib><creatorcontrib>Parwani, Abdul</creatorcontrib><creatorcontrib>Pieske, Burkert</creatorcontrib><creatorcontrib>Blaschke, Florian</creatorcontrib><creatorcontrib>Boldt, Leif-Hendrik</creatorcontrib><creatorcontrib>Haverkamp, Wilhelm</creatorcontrib><creatorcontrib>Wutzler, Alexander</creatorcontrib><title>Does the extent of left atrial arrhythmogenic substrate depend on the electroanatomical mapping technique: impact of pulmonary vein mapping catheter vs. ablation catheter</title><title>Europace (London, England)</title><addtitle>Europace</addtitle><description>In persistent atrial fibrillation (AF), left atrial low-voltage areas and complex fractionated atrial electrograms (CFAEs) have been thoroughly discussed as critical substrate points for AF perpetuation. Thus, in patients undergoing pulmonary vein isolation, these sites are often considered additional ablation targets. Currently, mapping techniques for these substrate indicators are still under discussion. The aim of this study was to evaluate the impact of different mapping catheters on the detection of low-voltage areas and CFAE.
Two bipolar voltage maps and two CFAE left atrial maps were obtained each in 30 patients undergoing catheter ablation of AF using the following two different catheters: A four-pole ablation catheter (MAP, mapping and ablation catheter) (electrode size: tip: 4 mm, band: 1 mm; inter-electrode spacing: 0.5-5-2 mm) and a 10-pole circular pulmonary vein mapping catheter (CMC) (electrode size: 1 mm; inter-electrode spacing: 7-7-7 mm). Successively, low-voltage and CFAE area sizes were then compared between the two catheters. Areas with a bipolar voltage of <0.5 mV were significantly smaller when obtained with the CMC compared with the MAP (8.9 ± 8.9 vs. 17.4 ± 11.7 cm², P < 0.001). This was also significantly different for a bipolar voltage of <0.2 mV (2.3 ± 4.6 vs. 6.2 ± 9.6 cm², P < 0.001). Complex fractionated atrial electrogram area sizes were significantly larger when obtained with the CMC compared with the MAP group (14.6 ± 10.9 vs. 19.4 ± 9.4 cm², P = 0.011).
Low-voltage and CFAE area size varies significantly between different mapping catheters. Mapping electrode settings have to be taken into consideration for the assessment of electroanatomical substrate of AF.</description><subject>Action Potentials</subject><subject>Aged</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Atrial Fibrillation - surgery</subject><subject>Cardiac Catheterization - instrumentation</subject><subject>Cardiac Catheters</subject><subject>Catheter Ablation - instrumentation</subject><subject>Electrophysiologic Techniques, Cardiac - instrumentation</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Pulmonary Veins - physiopathology</subject><subject>Pulmonary Veins - surgery</subject><subject>Reproducibility of Results</subject><subject>Signal Processing, Computer-Assisted</subject><issn>1099-5129</issn><issn>1532-2092</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNo9kUtPxCAUhYnR6PhYuzMs3dShUEpxZ3wnk7jRdUPprYNpoQIdnb_krxQdx4SEG_Kdc-_lIHSak4ucSDaHybtRaUjFR17xHTTLOaMZJZLupppImfGcygN0GMIbIURQyffRARWCVaQsZ-jrxkHAcQkYPiPYiF2He-giVtEb1WPl_XIdl4N7BWs0DlMTolcRcAsj2BY7uxH3oKN3yqroBqOTcFDjaOwrjqCX1rxPcInNkEb97TBO_eCs8mu8AmP_Wa2SVwSPV-ECq6ZX0ST_7esx2utUH-Dk7z5CL3e3z9cP2eLp_vH6apFpxqqYFWkxolWbjqgakFRWggjCW9Z2vGRaQFtUrZSsyxsqdEm5KBteqgRqURQFO0LnG9_RuzR3iPVggoa-VxbcFOq8YrxIn81IQucbVHsXgoeuHr0Z0l51TuqfgOptQPUmoKQ4-zOfmgHaf36bCPsGq_WTvw</recordid><startdate>20170801</startdate><enddate>20170801</enddate><creator>Huemer, Martin</creator><creator>Qaiyumi, Daniel</creator><creator>Attanasio, Philipp</creator><creator>Parwani, Abdul</creator><creator>Pieske, Burkert</creator><creator>Blaschke, Florian</creator><creator>Boldt, Leif-Hendrik</creator><creator>Haverkamp, Wilhelm</creator><creator>Wutzler, Alexander</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170801</creationdate><title>Does the extent of left atrial arrhythmogenic substrate depend on the electroanatomical mapping technique: impact of pulmonary vein mapping catheter vs. ablation catheter</title><author>Huemer, Martin ; Qaiyumi, Daniel ; Attanasio, Philipp ; Parwani, Abdul ; Pieske, Burkert ; Blaschke, Florian ; Boldt, Leif-Hendrik ; Haverkamp, Wilhelm ; Wutzler, Alexander</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c338t-48060cadcad78be929870705d3df563c7ed48d993f1b27c62576b56a929c74443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Action Potentials</topic><topic>Aged</topic><topic>Atrial Fibrillation - diagnosis</topic><topic>Atrial Fibrillation - physiopathology</topic><topic>Atrial Fibrillation - surgery</topic><topic>Cardiac Catheterization - instrumentation</topic><topic>Cardiac Catheters</topic><topic>Catheter Ablation - instrumentation</topic><topic>Electrophysiologic Techniques, Cardiac - instrumentation</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Pulmonary Veins - physiopathology</topic><topic>Pulmonary Veins - surgery</topic><topic>Reproducibility of Results</topic><topic>Signal Processing, Computer-Assisted</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huemer, Martin</creatorcontrib><creatorcontrib>Qaiyumi, Daniel</creatorcontrib><creatorcontrib>Attanasio, Philipp</creatorcontrib><creatorcontrib>Parwani, Abdul</creatorcontrib><creatorcontrib>Pieske, Burkert</creatorcontrib><creatorcontrib>Blaschke, Florian</creatorcontrib><creatorcontrib>Boldt, Leif-Hendrik</creatorcontrib><creatorcontrib>Haverkamp, Wilhelm</creatorcontrib><creatorcontrib>Wutzler, Alexander</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Europace (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huemer, Martin</au><au>Qaiyumi, Daniel</au><au>Attanasio, Philipp</au><au>Parwani, Abdul</au><au>Pieske, Burkert</au><au>Blaschke, Florian</au><au>Boldt, Leif-Hendrik</au><au>Haverkamp, Wilhelm</au><au>Wutzler, Alexander</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does the extent of left atrial arrhythmogenic substrate depend on the electroanatomical mapping technique: impact of pulmonary vein mapping catheter vs. ablation catheter</atitle><jtitle>Europace (London, England)</jtitle><addtitle>Europace</addtitle><date>2017-08-01</date><risdate>2017</risdate><volume>19</volume><issue>8</issue><spage>1293</spage><epage>1301</epage><pages>1293-1301</pages><issn>1099-5129</issn><eissn>1532-2092</eissn><abstract>In persistent atrial fibrillation (AF), left atrial low-voltage areas and complex fractionated atrial electrograms (CFAEs) have been thoroughly discussed as critical substrate points for AF perpetuation. Thus, in patients undergoing pulmonary vein isolation, these sites are often considered additional ablation targets. Currently, mapping techniques for these substrate indicators are still under discussion. The aim of this study was to evaluate the impact of different mapping catheters on the detection of low-voltage areas and CFAE.
Two bipolar voltage maps and two CFAE left atrial maps were obtained each in 30 patients undergoing catheter ablation of AF using the following two different catheters: A four-pole ablation catheter (MAP, mapping and ablation catheter) (electrode size: tip: 4 mm, band: 1 mm; inter-electrode spacing: 0.5-5-2 mm) and a 10-pole circular pulmonary vein mapping catheter (CMC) (electrode size: 1 mm; inter-electrode spacing: 7-7-7 mm). Successively, low-voltage and CFAE area sizes were then compared between the two catheters. Areas with a bipolar voltage of <0.5 mV were significantly smaller when obtained with the CMC compared with the MAP (8.9 ± 8.9 vs. 17.4 ± 11.7 cm², P < 0.001). This was also significantly different for a bipolar voltage of <0.2 mV (2.3 ± 4.6 vs. 6.2 ± 9.6 cm², P < 0.001). Complex fractionated atrial electrogram area sizes were significantly larger when obtained with the CMC compared with the MAP group (14.6 ± 10.9 vs. 19.4 ± 9.4 cm², P = 0.011).
Low-voltage and CFAE area size varies significantly between different mapping catheters. Mapping electrode settings have to be taken into consideration for the assessment of electroanatomical substrate of AF.</abstract><cop>England</cop><pmid>27738066</pmid><doi>10.1093/europace/euw185</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Europace (London, England), 2017-08, Vol.19 (8), p.1293-1301 |
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| source | PubMed (Medline); Open Access: Oxford University Press Open Journals; Oxford Journals Online |
| subjects | Action Potentials Aged Atrial Fibrillation - diagnosis Atrial Fibrillation - physiopathology Atrial Fibrillation - surgery Cardiac Catheterization - instrumentation Cardiac Catheters Catheter Ablation - instrumentation Electrophysiologic Techniques, Cardiac - instrumentation Equipment Design Female Heart Rate Humans Male Middle Aged Predictive Value of Tests Prospective Studies Pulmonary Veins - physiopathology Pulmonary Veins - surgery Reproducibility of Results Signal Processing, Computer-Assisted |
| title | Does the extent of left atrial arrhythmogenic substrate depend on the electroanatomical mapping technique: impact of pulmonary vein mapping catheter vs. ablation catheter |
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