scholarly journals Propagation Mapping Wave Collision Correlates to the Site of Successful Ablation During Voltage Mapping in Atrioventricular Nodal Reentry Tachycardia

2017 ◽  
Vol 8 (9) ◽  
pp. 2836-2842 ◽  
Author(s):  
Amy Van Aartsen ◽  
Ian Law ◽  
Jennifer Maldonado ◽  
Nicholas Von Bergen
Keyword(s):  
Successful Ablation ◽  
Voltage Mapping ◽  
Atrioventricular Nodal Reentry Tachycardia ◽  
Wave Collision ◽  
Reentry Tachycardia

Abstract 25: The Use of Voltage Mapping for Slow Pathway Visualization and Ablation of Atrioventricular Nodal Reentry Tachycardia in Pediatric and Young Adult Patients

2012 ◽  
Vol 111 (suppl_1) ◽  
Author(s):  
Lindsey Malloy ◽  
Ian Law ◽  
Nicholas Von Bergen
Keyword(s):  
Low Voltage ◽  
Pediatric Population ◽  
Adult Patients ◽  
Voltage Gradient ◽  
Slow Pathway ◽  
Anatomical Location ◽  
Voltage Mapping ◽  
Atrioventricular Nodal Reentry Tachycardia ◽  
Reentry Tachycardia ◽  
Lower Voltage

Atrioventricular nodal reentry tachycardia (AVNRT) is a common arrhythmia in both pediatric and adult patients. Ablation of the arrhythmia substrate has typically been guided by anatomical location and electrogram morphology within the triangle of Koch. Using an anatomic approach can be challenging because of unusual pathway locations and anatomic variance. The use of voltage gradient mapping has been proposed in adults to aid in identification of the “slow pathway”, guiding placement of the ablation applications. The purpose of this study was to evaluate this novel technique of voltage guided ablation of AVNRT in a pediatric patient population, with a smaller triangle of Koch. Patients with atrioventricular nodal reentry tachycardia at the University of Iowa Children’s Hospital who underwent voltage mapping within the slow pathway area were included. Using intracardiac electrical recordings, three-dimensional voltage maps of the right atrium were created. A voltage map identified a bridge of lower voltage signals surrounded by even lower voltage tissue. This bridge was used to guide cryoablation of the slow pathway. Patient demographics, appearance of the intracardiac voltage mapping, timing of procedure, lesions to success, and total number of lesions was obtained. In this study there were 29 patients with an average age of 14 years (range 7 to 20 years) who underwent AVNRT ablation with voltage mapping. Ten were male. In these patients there was procedural success (no inducible AVNRT, single AV node echo beat or less) in all patients. In 25 of 29 patients, there was an adequate lower voltage saddle to allow guided ablation. The successful ablation site was within the first three lesions in 15/25 patients. Total lesions ranged from 5-34. There has been recurrence in 1 patient over an average follow-up period of one year (range five months - twenty months). The use of voltage guided ablation of a low voltage saddle in atrioventricular nodal reentry tachycardia is a technique that appears to be effective and safe in the pediatric population and has the advantage of allowing an electrically guided ablation therapy. Voltage guided ablation of atrioventricular nodal reentry tachycardia is a safe and effective technique for ablating AVNRT.

scholarly journals Voltage bridge mapping in atrioventricular nodal reentry tachycardia ablation in adult population: results from a multicenter registry

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
A Costa ◽  
W Rauhe ◽  
C Martignani ◽  
B Igniatiuk ◽  
P Sabbatani ◽  
...  
Keyword(s):  
Low Voltage ◽  
Adult Population ◽  
Slow Pathway ◽  
Type I ◽  
Type Ii ◽  
Tricuspid Annulus ◽  
Successful Ablation ◽  
Atrioventricular Nodal Reentry Tachycardia ◽  
The Relationship ◽  
Reentry Tachycardia

Abstract Funding Acknowledgements Type of funding sources: None. Background The presence of Low Voltage Bridge (LVB) in Atrioventricular Nodal Reentry Tachycardia (AVNRT) ablation has been described in children populations. Slow pathway ablations visualizing and targeting the LVB has been described to be safe and effective. However, the incidence of LVB in AVNRT ablation has not been widely explored in adult population. Purpose We aim to investigate the presence of LVB in adult patients (pts) undergoing AVNRT ablation, and the relationship between the LVB and the successful ablation site. We have also investigated the correlations between the Koch’s triangle (KT) anatomy and biophysical pts data. Methods The observational registry prospectively collected data of 165 pts. undergoing AVNRT ablation guided by 3D electroanatomical mapping system (EnSite - Abott, St Paul, MN) in 6 EP centers. Gender: 90F – 75M (55% - 45%) - Age: 57 ± 17 ys (min 15 – max 87) - Weight: 73 ± 15 kgs (min 42 - max 150)  Prior of ablation a voltage map of KT was created using diagnostic and ablation catheters. We define as Type I LVB a clear, long area of low voltage within the KT between the CS ostium and the AV node with the base on the edge of the tricuspid annulus and Type II LVB a narrow low voltage channel between normal-voltage regions with the base on the edge of the tricuspid annulus. The relationship between LVB and successful site was evaluated at the end of the procedure. KT anatomical data were correlated to gender, age and weight. Results The LVB was identified in 134 pts (81%) with a prevalence of type I (91 - 68%) over type II (33 - 25%). In 10 pts (7%) the LVB did not match type I nor type II. When an LVB was identified, the correspondence between the LVB and the successful ablation site was verified in 117 pts (87%). In addition, a shorter RF time was applied when an LVB was found (396s vs 298s; p = 0.03). Strong correlations between KT anatomy and biophysical pts data were not identified. The distance between His electrograms and the successful ablation site weakly correlated (ρ = -0.24, p < 0.01) with pts age suggesting a shortening in the distance with age progression. Conclusion The visualization of the Low Voltage Bridge may be a helpful tool to guide AVNRT ablation in a large cohort of pts; furthermore it is associated with reduced RF applications time. The KT characteristics are difficult to be predicted a priori according to patient gender, age or weight.

Visualization of Atrioventricular Nodal Reentry Tachycardia Slow Pathways Using Voltage Mapping for Pediatric Catheter Ablation

2015 ◽  
Vol 10 (4) ◽  
pp. E172-E179 ◽  
Author(s):  
David W. Bearl ◽  
LuAnn Mill ◽  
John D. Kugler ◽  
John L. Prusmack ◽  
Christopher C. Erickson
Keyword(s):  
Catheter Ablation ◽  
Voltage Mapping ◽  
Atrioventricular Nodal Reentry Tachycardia ◽  
Reentry Tachycardia

scholarly journals Successful ablation of atrioventricular nodal reentry tachycardia following the atriopulmonary Fontan procedure

EP Europace ◽  
2006 ◽  
Vol 8 (10) ◽  
pp. 907-910 ◽  
Author(s):  
Dominic J. Abrams ◽  
Mark J. Earley ◽  
Simon C. Sporton ◽  
Richard J. Schilling
Keyword(s):  
Fontan Procedure ◽  
Successful Ablation ◽  
Atrioventricular Nodal Reentry Tachycardia ◽  
Reentry Tachycardia
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