Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Feasibility of single transseptal workflow with high-density mapping in atrial fibrillation recurrence after pulmonary vein isolation
Session:
Posters 4 - Écran 08 - Arritmologia Invasiva
Speaker:
Guilherme Portugal
Congress:
CPC 2018
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.4 Atrial Fibrillation - Treatment
Session Type:
Posters
FP Number:
---
Authors:
Guilherme Portugal; Mário Martins Oliveira; Pedro Silva Cunha; Bruno Tereno Valente; Madalena Coutinho Cruz; Rita Ilhão Moreira; Ana Sofia Delgado; Rui Cruz Ferreira
Abstract
<p>Background: <br /> <br /> Pulmonary vein (PV) reconnection is linked with early atrial fibrillation (AF) recurrence after PV isolation (PVI). Accurate mapping of ablation gaps is paramount to guide radiofrequency (RF) lesions and shorten procedural time. We report on the results of a single-puncture workflow using a high-density 20-pole catheter for PV reconnection mapping and ablation in AF recurrence after PVI. <br /> <br /> Methods: <br /> <br /> Consecutive patients undergoing an electrophysiological (EP) study for recurrent AF after index PVI between January 2016 and August 2017 were prospectively submitted to a single transseptal workflow. Access to the left atrium (LA) was achieved with fluoroscopic-guided transseptal puncture and high-density mapping of the LA was performed with a deflectable sheath and a high-density five-splined 20-pole mapping catheter. Ablation gaps as visualized on voltage and activation mapping were targeted for RF ablation and re-mapping was performed to confirm PVI. Procedural success was defined as bidirectional block. <br /> <br /> Results: <br /> <br /> 18 patients were included, mean age 56.1+/-11.3, 61.1% male sex, 61.1% paroxysmal AF and 38.9% persistent AF. Mean LA mapping volume was 161 +/- 37 mL. Patients were submitted to a median of 2 maps (range 2-4). Baseline high-density mapping took a mean duration of 22.4+/-10.3 mins for a mean 1179+/-601 points and showed PV reconnection in 17 of 18 patients (94%) – left superior PV in 72% (91% in the lateral ridge), left inferior PV in 50%, right superior PV in 50% and right inferior PV in 61%. After gap-guided RF ablation, repeat mapping (10.1 +/-4.9 mins for a mean 865+/-603 points) showed PV isolation with bidirectional block in 72% of patients. 5 patients (28%) required additional RF applications with repeat mapping. Mean procedural time was 155+/-44.6 mins. Patients who required additional lesions did not have a significantly prolonged procedural time (165+/- 52 mins vs. 152+/-44 mins, p=ns). No peri-procedural complications were observed. <br /> <br /> Conclusions: A single transseptal workflow with high-density mapping in AF recurrence ablation is feasible and allows identification of PV electrical reconnections in most of the patients. The lateral ridge of the left superior PV seems to be the typical site of gaps location. Additional lesions and remapping were required in a subset of patients and did not significantly prolong procedural time.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site
