Efficacy of the peak frequency map for left atrial posterior wall isolation

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Electrophysiology Pub Date : 2024-10-24 DOI:10.1111/jce.16477

Shintaro Yamagami MD, Suguru Nishiuchi MD, PhD, Tomohiro Sato MD, Masaya Akiyama CE, Yuta Nakano CE, Kondo Hirokazu MD, PhD, Toshihiro Tamura MD, PhD

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引用次数: 0

Abstract

Introduction

Complete isolation of the left atrial posterior wall (LAPW) is challenging owing to overlapping epicardial conduction. Peak frequency (PF) is a novel parameter that focuses on near- and far-field electrogram components. In this study, we aimed to determine whether transmural block completion is related to the ablation site PF.

Methods

We analyzed 44 consecutive patients undergoing initial LAPW isolation (LAPWI) between June 2023 and February 2024. Pre-LAPWI and PF maps were obtained using an HD-Grid catheter. In 17 of the 44 patients (Group-1), LAPWI was performed conventionally. In the remaining 27 patients (Group-2), PF-guided LAPWI was applied based on Group-1 results.

Results

In Group-1, the left atrial (LA) roof and floor line success rates were 58.8% and 76.5%, respectively. The average PF value in the roof lines of patients with a completed block line was significantly higher than that of the remaining patients (286.6 ± 29.3 Hz vs. 236.1 ± 40.9 Hz, p = .012), but the floor lines were similar. In Group-2, relatively high PF values were targeted to achieve complete block of the LA roof and floor lines, following the results obtained in Group-1. The LA roof line success rates (92.6% vs. 58.8%, p = .007), total number of radiofrequency (RF) applications (22.7 ± 5.6 vs. 27.6 ± 8.5, p = .03), and procedural time (32.6 ± 18.3 vs. 47.9 ± 25.6 min, p = .03) differed between Group-1 and Group-2.

Conclusion

Using a PF map for determining the optimal ablation line for LAPWI by RF catheter ablation is feasible.

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峰值频率图对左心房后壁隔离的功效。

简介：由于心外膜传导重叠，完全隔离左心房后壁（LAPW）具有挑战性。峰值频率（PF）是一个新颖的参数，侧重于近场和远场电图成分。在这项研究中，我们旨在确定跨壁阻滞的完成是否与消融部位的峰频有关：我们分析了 2023 年 6 月至 2024 年 2 月间接受初次 LAPWI（LAPWI）的 44 例连续患者。使用 HD-Grid 导管获取了 LAPWI 前和 PF 图。44 名患者中有 17 名（第 1 组）采用传统的 LAPWI 方法。其余 27 名患者（第 2 组）在第 1 组结果的基础上进行了 PF 引导的 LAPWI：结果：在第一组中，左心房（LA）顶线和底线的成功率分别为 58.8% 和 76.5%。已完成阻塞线的患者房顶线的平均 PF 值明显高于其余患者（286.6 ± 29.3 Hz vs. 236.1 ± 40.9 Hz，p = .012），但房底线的情况相似。在第 2 组中，根据第 1 组的结果，以相对较高的 PF 值为目标，以实现 LA 顶线和底线的完全阻断。第一组和第二组的 LA 顶线成功率（92.6% vs. 58.8%，p = .007）、射频 (RF) 应用总次数（22.7 ± 5.6 vs. 27.6 ± 8.5，p = .03）和手术时间（32.6 ± 18.3 vs. 47.9 ± 25.6 分钟，p = .03）均有所不同：结论：使用射频导管消融术确定 LAPWI 最佳消融线的 PF 图是可行的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiovascular Electrophysiology 医学-心血管系统

CiteScore

5.20

自引率

14.80%

发文量

433

审稿时长

3-6 weeks

期刊介绍： Journal of Cardiovascular Electrophysiology (JCE) keeps its readership well informed of the latest developments in the study and management of arrhythmic disorders. Edited by Bradley P. Knight, M.D., and a distinguished international editorial board, JCE is the leading journal devoted to the study of the electrophysiology of the heart.