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Impact of high-density map** on outcome of the second ablation for atrial fibrillation

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Abstract

Purpose

Identification of a conduction gap between the left atrium and pulmonary vein (LA-PV gap) and the circuit of atrial tachycardia after pulmonary vein isolation (PVI) is an important process during the second ablation for atrial fibrillation (AF). The high-density map** system RHYTHMIA® is useful for identification of an LA-PV gap and the circuit of atrial tachycardia. Therefore, this study was performed to investigate the effect of RHYTHMIA® in terms of the outcome of the second ablation for AF.

Methods

One hundred patients underwent a second ablation for AF in our institute from April 2015 to December 2018. We retrospectively evaluated 49 patients using RHYTHMIA® (group 1) and 51 patients using the conventional method with additional anatomical guide by CARTO® system.

Results

In group 1, we performed redo PVI for 41 patients with 49 LA-PV countable gaps and ablation for other atrial arrhythmias in 7 patients. In group 2, we performed redo PVI in 40 patients with 33 LA-PV countable gaps and ablation for other atrial arrhythmias in 9 patients. Three and two unstable arrhythmias in each group were not ablated. The final recurrence of atrial arrhythmia was significantly lower in group 1 than 2 (8/49 (16%) vs. 17/51 (33%), respectively; P = 0.017). Atrial arrhythmias other than AF after the second ablation occurred in only one patient in group 1 but seven patients in group 2.

Conclusion

Using high-density map** for the second ablation of AF was found to be superior to the conventional ablation method in terms of the suppression of atrial events in this study. This technique warrants further investigation.

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References

  1. Calkins H, Reynolds MR, Spector P, Sondhi M, Xu Y, Martin A, et al. Treatment of atrial fibrillation with antiarrhythmic drugs or radiofrequency ablation: two systematic literature reviews and meta-analyses. Circ Arrhythm Electrophysiol. 2009;2:349–61.

    Article  CAS  Google Scholar 

  2. Ganesan AN, Shipp NJ, Brooks AG, Kuklik P, Lau DH, Sanders P, et al. Long-term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta-analysis. J Am Heart Assoc. 2013. https://doi.org/10.1161/JAHA.112.004549.

  3. Jannik LP, Gunnar HG, Jim H, Arne J, Christian TP, Peter VR, et al. Temporal trends in atrial fibrillation recurrence rates after ablation between 2005 and 2014: a nationwide Danish cohort study. Eur Heart J. 2018;39:442–9.

    Article  Google Scholar 

  4. Perino AC, Leef GC, Cluckey A, Yunus FN, Askari M, et al. Secular trends in success rate of catheter ablation for atrial fibrillation: the SMASH-AF cohort. Am Heart J. 2019. https://doi.org/10.1016/j.ahj.2018.10.006.

  5. Hussein AA, Saliba WI, Martin DO, Bhargava M, Sherman M, ANP, et al. Natural history and long-term outcomes of ablated atrial fibrillation. Circ Arrhythm Electrophysiol. 2011;4:271–8.

    Article  Google Scholar 

  6. Mujovic´ N, Marinkovic´ M, Potpara TS, Geller L. Catheter ablation of lone atrial fibrillation. Curr Pharm Des. 2015; 21: 591–612.

  7. Sadek MM, Maeda S, Chik W, Santangeli P, Zado ES, Schaller RD, et al. Recurrent atrial arrhythmias in the setting of chronic pulmonary vein isolation. Heart Rhythm. 2016. https://doi.org/10.1016/j.hrthm.2016.08.026.

  8. Maury P, Monteil B, Marty L, Duparc A, Mondoly P, Rollin A. Three-dimensional map** in the electrophysiological laboratory. Arch Cardiovasc Dis. 2018;111:456–64.

    Article  Google Scholar 

  9. Jones DG, McCready JW, Kaba RA, Ahsan SY, Lyne JC, Wang J, et al. A multipurpose spiral high-density map** catheter: initial clinical experience in complex atrial arrhythmias. J Interv Card Electrophysiol. 2011;31:225–35.

    Article  Google Scholar 

  10. Nakagawa H, Ikeda A, Sharma T, Lazzara R, Jackman WM. Rapid high resolution electroanatomical map**: evaluation of a new system in a canine atrial linear lesion model. Circ Arrhythm Electrophysiol. 2012;5:417–24.

    Article  Google Scholar 

  11. Mantziari L, Butcher C, Kontogeorgis A, Panikker S, Roy K, Markides V, et al. Utility of a novel rapid high-resolution map** system in the catheter ablation of arrhythmias: an initial human experience of map** the atria and the left ventricle. JACC Electrophysiol. 2015;1:411–20.

    Article  Google Scholar 

  12. Bollmann A, Hilbert S, John S, Kosiuk J, Hindricks G. Insights from preclinical ultra high-density electroanatomical sinus node map**. Europace. 2015;17:489–94.

    Article  Google Scholar 

  13. Frontera A, Takigawa M, Martin R, Thompson N, Haïssaguerre M, Derval N, et al. Electrogram signature of specific ctivation patterns: analysis of atrial tachycardias at high-density endocardial map**. Heart Rhythm. 2018;15:28–37.

    Article  Google Scholar 

  14. García-Bolao I, Ballesteros G, Ramos P, Menéndez D, Erkiaga A, Neglia R, et al. Identification of pulmonary vein reconnection gaps with high-density map** in redo atrial fibrillation ablation procedures. Europace. 2018. https://doi.org/10.1093/europace/eux184.

  15. Masuda M, Fujita M, Iida O, Okamoto S, Ishihara T, Mano T, et al. The identification of conduction gaps after pulmonary vein isolation using a new electroanatomic map** system. Heart Rhythm. 2017;11:1606–14.

    Article  Google Scholar 

  16. Knecht S, Veenhuyzen G, O'Neill, Wright M, Nault I, Haïssaguerre M, et al. Atrial tachycardias encountered in the context of catheter ablation for atrial fibrillation part ii: map** and ablation. Pacing Clin Electrophysiol. 2009. https://doi.org/10.1111/j.1540-8159.2009.02315.x

  17. Kuck KH, Hoffmann BA, Ernst S, Wegscheider K, Treszl A, Metzner A, et al; Gap-AF–AFNET 1 Investigators. Impact of complete versus incomplete circumferential lines around the pulmonary veins during catheter ablation of paroxysmal atrial fibrillation: results from the Gap-Atrial Fibrillation-German Atrial Fibrillation Competence Network 1 Trial. Circ Arrhythm Electrophysiol 2016. https://doi.org/10.1161/CIRCEP.115.003337

  18. Satomi K. Electrophysiological characteristics of atrial tachycardia after pulmonary vein isolation of atrial fibrillation. Circ J. 2010;74:1051–8.

    Article  Google Scholar 

  19. Augello G, Vicedomini G, Saviano M, Crisa S, Mazzone P, Pappone C, et al. Pulmonary vein isolation after circumferential pulmonary vein ablation: comparison between lasso and three-dimensional electroanatomical assessment of complete electrical disconnection. Heart Rhythm. 2009;6:1706–13.

    Article  Google Scholar 

  20. Mori H, Muraji S, Sumitomo N, Kato R, Kobayashi T, Matsumoto K, et al. Safety and accuracy of the Rhythmia map** system in pediatric patients. Heart Rhythm. 2019;16:388–94.

    Article  Google Scholar 

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Acknowledgments

R Kato supervised research design and details. S Iwanaga confirmed whether all echo cardiographic assessment was properly performed. R Kato, K Goto, T Nagase, H mori, and Y Ikeda joined as major ablation operators. H Mori, K Tsutsui, S Tanaka, S Asano, M Tawara, M Yukino, and S Hasegawa cooperated in collecting data. S Nakano, T Muramatsu, and K Matsumoto approved this article.

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Authors and Affiliations

  1. Department of Cardiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan

    Yoshifumi Ikeda, Ritsushi Kato, Hitoshi Mori, Kenta Tsutsui, Koji Goto, Takahiko Nagase, Sayaka Tanaka, Sou Asano, Mai Tawara, Midori Yukino, Saki Hasegawa, Shintaro Nakano, Shiro Iwanaka, Toshihiro Muramatsu & Kazuo Matsumoto

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  1. Yoshifumi Ikeda
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  2. Ritsushi Kato
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  3. Hitoshi Mori
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  4. Kenta Tsutsui
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  5. Koji Goto
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  6. Takahiko Nagase
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  7. Sayaka Tanaka
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  8. Sou Asano
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  9. Mai Tawara
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  10. Midori Yukino
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  11. Saki Hasegawa
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  12. Shintaro Nakano
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  13. Shiro Iwanaka
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  14. Toshihiro Muramatsu
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  15. Kazuo Matsumoto
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Corresponding author

Correspondence to Ritsushi Kato.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval and informed consent

This study was approved as a retrospective study by the institutional review board of Saitama Medical University, International Medical center (18–226). An informed consent is not necessary in principle in a retrospective study. However, the information of this study is published on the homepage of our institution, and all study subjects have the opportunity to refuse participation in this study.

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Ikeda, Y., Kato, R., Mori, H. et al. Impact of high-density map** on outcome of the second ablation for atrial fibrillation. J Interv Card Electrophysiol 60, 135–146 (2021). https://doi.org/10.1007/s10840-020-00716-y

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  • DOI: https://doi.org/10.1007/s10840-020-00716-y

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