SIMULTANEOUS HYBRID ABLATION WITH EPI-ENDOCARDIAL MAPPING FOR THE TREATMENT OF LONG STANDING PERSISTENT ATRIAL FIBRILLATION

2021 ◽  
Vol 37 (10) ◽  
pp. S54-S55
Author(s):  
S Hassan ◽  
S Paleczny ◽  
D Redfearn ◽  
B Glover ◽  
A Enriquez ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
Endocardial Mapping ◽  
Hybrid Ablation

Facilitated Coupling of Magnetic Introducers During Thoracoscopic Ablation of Atrial Fibrillation

2019 ◽  
Vol 14 (5) ◽  
pp. 480-482
Author(s):  
Syed M. Ali Hassan ◽  
Benedict Glover ◽  
Andres Enriquez ◽  
Gianluigi Bisleri
Keyword(s):  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
Epicardial Ablation ◽  
Ablation Procedure ◽  
Linear Ablation ◽  
Surgical Device ◽  
Hybrid Ablation

A 51-year-old man with long-standing persistent atrial fibrillation underwent a hybrid ablation procedure with right thoracoscopic epicardial ablation. Fluoroscopy was utilized in a novel way to visualize the magnetic tip catheters of the linear ablation surgical device and allow easier coupling of the tips, making this procedure more efficient and reducing the risk of improper positioning of the ablation device.

scholarly journals Endocardial-Epicardial Phase Mapping of Prolonged Persistent Atrial Fibrillation Recordings

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
Ramanathan Parameswaran ◽  
Jonathan M. Kalman ◽  
Alistair Royse ◽  
John Goldblatt ◽  
Marco Larobina ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
Temporal Heterogeneity ◽  
Activation Patterns ◽  
3 Dimensional ◽  
Transmural Migration ◽  
Endocardial Mapping ◽  
Phase Mapping ◽  
Insight Into ◽  
Activation Mapping

Background: Endocardial-epicardial dissociation and focal breakthroughs in humans with atrial fibrillation (AF) have been recently demonstrated using activation mapping of short 10-second AF segments. In the current study, we used simultaneous endo-epi phase mapping to characterize endo-epi activation patterns on long segments of human persistent AF. Methods: Simultaneous intraoperative mapping of endo- and epicardial lateral right atrium wall was performed in patients with persistent AF using 2 high-density grid catheters (16 electrodes, 3 mm spacing). Filtered unipolar and bipolar electrograms of continuous 2-minute AF recordings and electrodes locations were exported for phase analyses. We defined endocardial-epicardial dissociation as phase difference of ≥20 ms between paired endo-epi electrodes. Wavefronts were classified as rotations, single wavefronts, focal waves, or disorganized activity as per standard criteria. Endo-Epi wavefront patterns were simultaneously compared on dynamic phase maps. Complex fractionated electrograms were defined as bipolar electrograms with ≥5 directional changes occupying at least 70% of sample duration. Results: Fourteen patients with persistent AF undergoing cardiac surgery were included. Endocardial-epicardial dissociation was seen in 50.3% of phase maps with significant temporal heterogeneity. Disorganized activity (Endo: 41.3% versus Epi: 46.8%, P =0.0194) and single wavefronts (Endo: 31.3% versus Epi: 28.1%, P =0.129) were the dominant patterns. Transient rotations (Endo: 22% versus Epi: 19.2%, P =0.169; mean duration: 590±140 ms) and nonsustained focal waves (Endo: 1.2% versus Epi: 1.6%, P =0.669) were also observed. Apparent transmural migration of rotational activations (n=6) from the epi- to the endocardium was seen in 2 patients. Electrogram fractionation was significantly higher in the epicardium than endocardium (61.2% versus 51.6%, P <0.0001). Conclusions: Simultaneous endo-epi phase mapping of prolonged human persistent AF recordings shows significant Endocardial-epicardial dissociation marked temporal heterogeneity, discordant and transitioning wavefronts patterns and complex fractionations. No sustained focal activity was observed. Such complex 3-dimensional interactions provide insight into why endocardial mapping alone may not fully characterize the AF mechanism and why endocardial ablation may not be sufficient. Graphic Abstract: A graphic abstract is available for this article.

scholarly journals Staged hybrid ablation for persistent and longstanding persistent atrial fibrillation effectively restores sinus rhythm in long-term observation

2017 ◽  
Vol 1 ◽  
pp. 109-117 ◽  
Author(s):  
Michal Zembala ◽  
Krzysztof Filipiak ◽  
Oskar Kowalski ◽  
Piotr Buchta ◽  
Tomasz Niklewski ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Persistent Atrial Fibrillation ◽  
Hybrid Ablation ◽  
Long Term Observation

scholarly journals Comparative Effectiveness of Hybrid Ablation Versus Endocardial Catheter Ablation Alone in Patients With Persistent Atrial Fibrillation

2017 ◽  
Vol 3 (4) ◽  
pp. 341-349 ◽  
Author(s):  
David C. Kress ◽  
Lynn Erickson ◽  
Indrajit Choudhuri ◽  
Jodi Zilinski ◽  
Tadele Mengesha ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Comparative Effectiveness ◽  
Persistent Atrial Fibrillation ◽  
Hybrid Ablation
Sign in / Sign up

Export Citation Format

Share Document