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Journal of Interventional Cardiac Electrophysiology

Erschienen in:

25.10.2019 | MULTIMEDIA REPORT

Utility of a ripple map for the interpretation of atrial propagation during atrial tachycardia

verfasst von: Atsuhiko Yagishita, Yoshihide Takahashi, Mihoko Kawabata, Masakazu Kaneko, Masahiro Sekigawa, Tasuku Yamamoto, Kikou Akiyoshi, Yasuhiro Shirai, Shingo Maeda, Shu Yamashita, Masahito Suzuki, Takeshi Sasaki, Masahiko Goya, Kenzo Hirao

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 3/2019

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Abstract

Purpose

Ripple map (RM) is a novel method for displaying activation pattern on the surface of a cardiac chamber. The aim of this study was to determine the utility of the RM in interpreting the atrial propagation in atrial tachycardia (AT) in comparison with a conventional local activation (LAT) map.

Methods

Three-dimensional electroanatomical mapping and ablation of AT were performed using multielectrode catheters and the CARTO3 ConfiDENSE Module (Biosense Webster). LAT maps and RMs were retrospectively reviewed by two independent observers who were blinded to the ablation results.

Results

High-density maps (1683 ± 1362 points) of 45 ATs (274 ± 64 ms; macroreentry 28, focal 17) were obtained in 39 patients. Of the 45 ATs, 41 (91%) were terminated by catheter ablation. A retrospective review of the LAT map alone by two observers resulted in correct diagnosis in 27% (12 ATs), whereas additional reviews of the RMs improved the diagnostic accuracy to 80% (36 ATs, P < 0.001). The diagnostic accuracy using the RM was equally high for macroreentrant (79%) and focal ATs (82%, P = 1.000). Of the 33 LAT maps in disagreement with the observers, adjusting the window-of-interest (WOI) after reviewing the RMs achieved diagnostic agreement of 91% (30 ATs).

Conclusion

RMs allow us to have precise understanding of the atrial propagation on high-density CARTO maps for both focal and macroreentrant ATs, which is particularly useful for cases with difficult-to-interpret LAT maps.

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Titel: Utility of a ripple map for the interpretation of atrial propagation during atrial tachycardia
verfasst von: Atsuhiko Yagishita
Yoshihide Takahashi
Mihoko Kawabata
Masakazu Kaneko
Masahiro Sekigawa
Tasuku Yamamoto
Kikou Akiyoshi
Yasuhiro Shirai
Shingo Maeda
Shu Yamashita
Masahito Suzuki
Takeshi Sasaki
Masahiko Goya
Kenzo Hirao
Publikationsdatum: 25.10.2019
Verlag: Springer US
Erschienen in: Journal of Interventional Cardiac Electrophysiology / Ausgabe 3/2019
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI: https://doi.org/10.1007/s10840-019-00638-4

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Utility of a ripple map for the interpretation of atrial propagation during atrial tachycardia