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Find Me If You Can: First Clinical Experience Using the Novel CARTOFINDER Algorithm in a Routine Workflow for Atrial Fibrillation Ablation

Aims: The CARTOFINDER module allows for simultaneous and automated detection of repetitive focal and rotational activations in patients with atrial arrhythmias. This study aimed to validate the CARTOFINDER algorithm for the detection of potential drivers for atrial fibrillation (AF) and to access th...

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Autores principales: Unland, Robin, Bergau, Leonard, El Hamriti, Mustapha, Guckel, Denise, Piran, Misagh, Fink, Thomas, Sciacca, Vanessa, Köerperich, Hermann, Chmelevsky, Mikhail, Imnadze, Guram, Khalaph, Moneeb, Braun, Martin, Sommer, Philipp, Sohns, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269300/
https://www.ncbi.nlm.nih.gov/pubmed/34279463
http://dx.doi.org/10.3390/jcm10132979
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author Unland, Robin
Bergau, Leonard
El Hamriti, Mustapha
Guckel, Denise
Piran, Misagh
Fink, Thomas
Sciacca, Vanessa
Köerperich, Hermann
Chmelevsky, Mikhail
Imnadze, Guram
Khalaph, Moneeb
Braun, Martin
Sommer, Philipp
Sohns, Christian
author_facet Unland, Robin
Bergau, Leonard
El Hamriti, Mustapha
Guckel, Denise
Piran, Misagh
Fink, Thomas
Sciacca, Vanessa
Köerperich, Hermann
Chmelevsky, Mikhail
Imnadze, Guram
Khalaph, Moneeb
Braun, Martin
Sommer, Philipp
Sohns, Christian
author_sort Unland, Robin
collection PubMed
description Aims: The CARTOFINDER module allows for simultaneous and automated detection of repetitive focal and rotational activations in patients with atrial arrhythmias. This study aimed to validate the CARTOFINDER algorithm for the detection of potential drivers for atrial fibrillation (AF) and to access their potential impact on individual arrhythmia substrates. Methods: Fifty consecutive patients underwent AF ablation for persistent AF (PERS), using a 3D-mapping system with the integrated CARTOFINDER module. Regions of interest (ROIs) were identified before and after ablation, and their spatial and temporal relationship was correlated with areas of fibrosis. Results: Procedural success was achieved in all patients and 42% received ablation beyond pulmonary vein isolation (PVI). AF termination was observed in 6 patients (12%). The mean procedure duration was 134 ± 29 min. ROIs were revealed in all patients (mean n = 77 ± 52) and there was no statistical evidence for a predilection site. There was no significant anatomical correlation between ROIs and bipolar low voltage. Remapping confirmed the elimination of ROIs in relation to the individual ablation site, a limited reproducibility of rotational ROIs and persistent focal activity over time in some anatomical segments. ROIs were not a predictor for AF recurrence during following ablation. Conclusions: CARTOFINDER mapping can be integrated into a routine workflow for AF ablation. ROIs could be discriminated in all patients and an ablation effect was observed in some patients, whereas persistent activity was found in certain anatomical segments, even after ablation. ROIs might be an additional ablation target when we are able to understand the individual substrate.
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spelling pubmed-82693002021-07-10 Find Me If You Can: First Clinical Experience Using the Novel CARTOFINDER Algorithm in a Routine Workflow for Atrial Fibrillation Ablation Unland, Robin Bergau, Leonard El Hamriti, Mustapha Guckel, Denise Piran, Misagh Fink, Thomas Sciacca, Vanessa Köerperich, Hermann Chmelevsky, Mikhail Imnadze, Guram Khalaph, Moneeb Braun, Martin Sommer, Philipp Sohns, Christian J Clin Med Article Aims: The CARTOFINDER module allows for simultaneous and automated detection of repetitive focal and rotational activations in patients with atrial arrhythmias. This study aimed to validate the CARTOFINDER algorithm for the detection of potential drivers for atrial fibrillation (AF) and to access their potential impact on individual arrhythmia substrates. Methods: Fifty consecutive patients underwent AF ablation for persistent AF (PERS), using a 3D-mapping system with the integrated CARTOFINDER module. Regions of interest (ROIs) were identified before and after ablation, and their spatial and temporal relationship was correlated with areas of fibrosis. Results: Procedural success was achieved in all patients and 42% received ablation beyond pulmonary vein isolation (PVI). AF termination was observed in 6 patients (12%). The mean procedure duration was 134 ± 29 min. ROIs were revealed in all patients (mean n = 77 ± 52) and there was no statistical evidence for a predilection site. There was no significant anatomical correlation between ROIs and bipolar low voltage. Remapping confirmed the elimination of ROIs in relation to the individual ablation site, a limited reproducibility of rotational ROIs and persistent focal activity over time in some anatomical segments. ROIs were not a predictor for AF recurrence during following ablation. Conclusions: CARTOFINDER mapping can be integrated into a routine workflow for AF ablation. ROIs could be discriminated in all patients and an ablation effect was observed in some patients, whereas persistent activity was found in certain anatomical segments, even after ablation. ROIs might be an additional ablation target when we are able to understand the individual substrate. MDPI 2021-07-02 /pmc/articles/PMC8269300/ /pubmed/34279463 http://dx.doi.org/10.3390/jcm10132979 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Unland, Robin
Bergau, Leonard
El Hamriti, Mustapha
Guckel, Denise
Piran, Misagh
Fink, Thomas
Sciacca, Vanessa
Köerperich, Hermann
Chmelevsky, Mikhail
Imnadze, Guram
Khalaph, Moneeb
Braun, Martin
Sommer, Philipp
Sohns, Christian
Find Me If You Can: First Clinical Experience Using the Novel CARTOFINDER Algorithm in a Routine Workflow for Atrial Fibrillation Ablation
title Find Me If You Can: First Clinical Experience Using the Novel CARTOFINDER Algorithm in a Routine Workflow for Atrial Fibrillation Ablation
title_full Find Me If You Can: First Clinical Experience Using the Novel CARTOFINDER Algorithm in a Routine Workflow for Atrial Fibrillation Ablation
title_fullStr Find Me If You Can: First Clinical Experience Using the Novel CARTOFINDER Algorithm in a Routine Workflow for Atrial Fibrillation Ablation
title_full_unstemmed Find Me If You Can: First Clinical Experience Using the Novel CARTOFINDER Algorithm in a Routine Workflow for Atrial Fibrillation Ablation
title_short Find Me If You Can: First Clinical Experience Using the Novel CARTOFINDER Algorithm in a Routine Workflow for Atrial Fibrillation Ablation
title_sort find me if you can: first clinical experience using the novel cartofinder algorithm in a routine workflow for atrial fibrillation ablation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269300/
https://www.ncbi.nlm.nih.gov/pubmed/34279463
http://dx.doi.org/10.3390/jcm10132979
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