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Evaluation of the use of open window mapping with high density cateter in patients with Wolff-Parkinson-White in a tertiary care unit
Session:
Sessão de Posters 41 - Taquiarritmias supraventriculares
Speaker:
Priscilla Santos
Congress:
CPC 2024
Topic:
C. Arrhythmias and Device Therapy
Theme:
04. Arrhythmias, General
Subtheme:
04.6 Arrhythmias, General – Clinical
Session Type:
Cartazes
FP Number:
---
Authors:
Priscilla Marques Dos Santos; Guilherme Portugal; Pedro Cunha; Ana Lousinha; Bruno Valente; Helder Santos; Sérgio Laranjo; Mario Oliveira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">The evolution of electroanatomical mapping has allowed the treatment of tachyarrhythmias more effectively, reducing the recurrence rate, allowing less exposure of the patient and team to fluoroscopy and with less chance of complications. In acessory pathways, the use of the open window mapping (OWM) technique uses the automatic inclusion of points corresponding to atrial and ventricular signals with greater fusion, creating maps with better visualization of the activation exit location for the chamber of interest. The aim of this stud was to identify the characteristics of electrophysiological studies carried out with the OWM technique in a population with ventricular pre-excitation syndrome in a tertiary unit in Lisbon.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methodology: A retrospective analysis was carried out on patients with Wolff-Parkinson-White syndrome who underwent an electrophysiological study using the open window technique for mapping the accessory pathway and treatment from March 2020 to November 2023. Unlike conventional mapping techniques that use point-by-point annotations and depend on an interpretation of the electrograms by the operator, the OWM technique automatically annotates local activation, using the clearest unipolar signal (maximum dV/dt) synchronized with the bipolar signal on the mapping catheter, collecting points on both sides of the atrioventricular ring more accurately, regardless of the chamber in which it is positioned.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results: 69 data from electrophysiological studies of patients diagnosed with WPW were included. Of these, 40 were male and 29 were female. 32 right pathways, 30 left pathways and 7 perihisian tracts were identified. Among the diagnoses, 62 had a correlation between the ECG and the electrophysiological finding. Treatment was carried out with radiofrequency in 61 patients; 7 were treated with cryoablation and 1 patient was not treated due to high risk of atrioventricular block (AVB). The fluoroscopy time was zero in 30 studies and the exams with the longest exposure time were routes located on the left that require transseptal puncture. The treatment was carried out successfully in 62 patients. Those that were unsuccessful were due to pain intolerance, high risk of AVB and a route with probable epicardial extension that awaits a new approach. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusion: Data analysis demonstrated that the use of open window mapping increases the accuracy in identifying the location of the accessory pathway than conventional techniques, which allows the electrophysiologist to choose the best therapeutic approach and t hus obtain greater effectiveness, a lower recurrence rate and less possibility of complications.</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"> </p>
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