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Review
. 2021 May 17:16:e21.
doi: 10.15420/ecr.2020.39. eCollection 2021 Feb.

Mapping Technologies for Catheter Ablation of Atrial Fibrillation Beyond Pulmonary Vein Isolation

Giulio La Rosa  1   2 , Jorge G Quintanilla  1   2   3 , Ricardo Salgado  2 , Juan José González-Ferrer  2   3 , Victoria Cañadas-Godoy  2   3 , Julián Pérez-Villacastín  2   3   4 , Nicasio Pérez-Castellano  2   3   4 , José Jalife  1   3 , David Filgueiras-Rama  1   2   3
Affiliations
Review

Mapping Technologies for Catheter Ablation of Atrial Fibrillation Beyond Pulmonary Vein Isolation

Giulio La Rosa et al. Eur Cardiol. .

Abstract

Catheter ablation remains the most effective and relatively minimally invasive therapy for rhythm control in patients with AF. Ablation has consistently shown a reduction of arrhythmia-related symptoms and significant improvement in patients' quality of life compared with medical treatment. The ablation strategy relies on a well-established anatomical approach of effective pulmonary vein isolation. Additional anatomical targets have been reported with the aim of increasing procedure success in complex substrates. However, larger ablated areas with uncertainty of targeting relevant regions for AF initiation or maintenance are not exempt from the potential risk of complications and pro-arrhythmia. Recent developments in mapping tools and computational methods for advanced signal processing during AF have reported novel strategies to identify atrial regions associated with AF maintenance. These novel tools - although mainly limited to research series - represent a significant step forward towards the understanding of complex patterns of propagation during AF and the potential achievement of patient-tailored AF ablation strategies for the near future.

Keywords: AF; catheter ablation; instantaneous frequency modulation; mapping technologies; rotors.

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Conflict of interest statement

Disclosure: DFR, JGQ, JPV and NPC are inventors of the patent #EP3636147A1. All other authors have no conflicts of interest to declare. Funding: The CNIC is supported by the Spanish Ministry of Science and Innovation and the Pro-CNIC Foundation, and is a Severo Ochoa Center of Excellence (SEV-2015-0505). This study was supported by the European Regional Development Fund and the Spanish Ministry of Science and Innovation (PID2019-109329RB-I00). The study was also partially supported by the Fundación Interhospitalaria para la Investigación Cardiovascular and the Fundación Salud 2000.

Figures

Figure 1:
Figure 1:. Panoramic and Sequential Phase-mapping Approaches in Experimental Settings and in Patients With AF
Figure 2:
Figure 2:. Schematics of Basket and Sequential Electrogram-based Mapping Approaches in Patients With AF
Figure 3:
Figure 3:. Other Basket Electrogram-based Mapping Systems in Patients With AF
See this image and copyright information in PMC

References

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