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Rapid detection of isthmus block and rhythm change using local electrogram changes during complex atrial flutter ablation
AIMS: Multiple re-entry circuits may operate simultaneously in the atria in the form of dual loop re-entry using a common isthmus, or multiple re-entrant loops without a common isthmus. When two or more re-entrant circuits coexist, ablation of an individual isthmus may lead to a seamless transition...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10103578/ https://www.ncbi.nlm.nih.gov/pubmed/36106617 http://dx.doi.org/10.1093/europace/euac161 |
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author | Padanilam, Benzy J Whittam, Sarah W Clark, Brad A Olson, Jeffrey A Nair, Girish V Joshi, Sandeep A Prystowsky, Eric N Patel, Parin J Gilge, Jasen L |
author_facet | Padanilam, Benzy J Whittam, Sarah W Clark, Brad A Olson, Jeffrey A Nair, Girish V Joshi, Sandeep A Prystowsky, Eric N Patel, Parin J Gilge, Jasen L |
author_sort | Padanilam, Benzy J |
collection | PubMed |
description | AIMS: Multiple re-entry circuits may operate simultaneously in the atria in the form of dual loop re-entry using a common isthmus, or multiple re-entrant loops without a common isthmus. When two or more re-entrant circuits coexist, ablation of an individual isthmus may lead to a seamless transition (without significant changes in surface electrocardiogram, coronary sinus activation or tachycardia cycle length) to a second rhythm, and the isthmus block can go unnoticed. METHODS AND RESULTS: We hypothesize and subsequently illustrate in three patient cases, methods to rapidly identify a transition in the rhythm and isthmus block using local electrogram changes at the ablation site. CONCLUSION: Local activation sequence changes, electrogram timing, and the behaviour of pre-existing double potentials can reveal isthmus block promptly when rhythm transitions occur during ablation of multiloop re-entry tachycardias. |
format | Online Article Text |
id | pubmed-10103578 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-101035782023-04-15 Rapid detection of isthmus block and rhythm change using local electrogram changes during complex atrial flutter ablation Padanilam, Benzy J Whittam, Sarah W Clark, Brad A Olson, Jeffrey A Nair, Girish V Joshi, Sandeep A Prystowsky, Eric N Patel, Parin J Gilge, Jasen L Europace Technical Issues AIMS: Multiple re-entry circuits may operate simultaneously in the atria in the form of dual loop re-entry using a common isthmus, or multiple re-entrant loops without a common isthmus. When two or more re-entrant circuits coexist, ablation of an individual isthmus may lead to a seamless transition (without significant changes in surface electrocardiogram, coronary sinus activation or tachycardia cycle length) to a second rhythm, and the isthmus block can go unnoticed. METHODS AND RESULTS: We hypothesize and subsequently illustrate in three patient cases, methods to rapidly identify a transition in the rhythm and isthmus block using local electrogram changes at the ablation site. CONCLUSION: Local activation sequence changes, electrogram timing, and the behaviour of pre-existing double potentials can reveal isthmus block promptly when rhythm transitions occur during ablation of multiloop re-entry tachycardias. Oxford University Press 2022-09-15 /pmc/articles/PMC10103578/ /pubmed/36106617 http://dx.doi.org/10.1093/europace/euac161 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Technical Issues Padanilam, Benzy J Whittam, Sarah W Clark, Brad A Olson, Jeffrey A Nair, Girish V Joshi, Sandeep A Prystowsky, Eric N Patel, Parin J Gilge, Jasen L Rapid detection of isthmus block and rhythm change using local electrogram changes during complex atrial flutter ablation |
title | Rapid detection of isthmus block and rhythm change using local electrogram changes during complex atrial flutter ablation |
title_full | Rapid detection of isthmus block and rhythm change using local electrogram changes during complex atrial flutter ablation |
title_fullStr | Rapid detection of isthmus block and rhythm change using local electrogram changes during complex atrial flutter ablation |
title_full_unstemmed | Rapid detection of isthmus block and rhythm change using local electrogram changes during complex atrial flutter ablation |
title_short | Rapid detection of isthmus block and rhythm change using local electrogram changes during complex atrial flutter ablation |
title_sort | rapid detection of isthmus block and rhythm change using local electrogram changes during complex atrial flutter ablation |
topic | Technical Issues |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10103578/ https://www.ncbi.nlm.nih.gov/pubmed/36106617 http://dx.doi.org/10.1093/europace/euac161 |
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