Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan;67(1):43-51.
doi: 10.1007/s10840-022-01121-3. Epub 2022 Jan 17.

Clinical impact of high-density mapping on the acute and long term outcome of atypical atrial flutter ablations

Andrea Di Cori  1 , Lorenzo Mazzocchetti  2 , Matteo Parollo  2 , Mario Giannotti  2 , Antonio Canu  2 , Valentina Barletta  2 , Salvatore Della Volpe  2 , Raffaele De Lucia  2 , Stefano Viani  2 , Luca Segreti  2 , Ezio Soldati  2 , Giulio Zucchelli  2 , Maria Grazia Bongiorni  2
Affiliations

Clinical impact of high-density mapping on the acute and long term outcome of atypical atrial flutter ablations

Andrea Di Cori et al. J Interv Card Electrophysiol. 2024 Jan.

Abstract

Purpose: We evaluated the clinical impact of the high-density (HD) mapping compared with the standard low-density (LD) ablation catheter mapping technique in the treatment of AFLs.

Methods: We retrospectively evaluated short and long outcomes of patients approached with an HD and a LD electro-anatomical strategy for atypical AFLs.

Results: Eighty-seven patients were included. Patients were almost male (60%), relatively old (65 ± 8 years), with a moderate CHA2DS2Vasc score (2.3 ± 1.3), a preserved ejection fraction (58 ± 6), and moderate atrial dilatation (44 ± 7 mm). Baseline clinical characteristics were comparable between groups (p = NS). Among AFLs, 10 (11%) were located in the right and 78 (89%) in the left atrium, including 22 (28%) roof dependent and 37 (47%) mitral dependent (p = NS). Sinus rhythm restoration during ablation was more frequently observed in the HD group (79% vs 56%, p = 0.037), without differences in mapping time, procedural time, and radiological dose (p = NS). Overall AFL/AT/AF recurrence rate at 1, 2, and 3 years was lower in the HD group (14% vs 37% p = 0.02, 14% vs 48% p = 0.002 and 14% vs 50% p < 0.001, respectively) with a time-dependent trend only in the LD group (37% vs 48% vs 50% at 1, 2, and 3 years respectively, p = 0.059). HD mapping (OR 0.17; 95% CI 0.04-0.66) and younger age (OR 1.09; 95% CI 1.01-1.19) resulted independent predictors of overall arrhythmias at follow-up.

Conclusions: Short- and long-term outcomes of atypical AFL ablation were better in the case of HD mapping, which resulted independent predictor of arrhythmia recurrences.

Keywords: Atypical atrial flutter; Electro-anatomical map; High-density mapping.

PubMed Disclaimer

References

    1. Shah D, Jaïs P, Haïssaguerre M. Electrophysiological evaluation and ablation of atypical right atrial flutter. Card Electrophysiol Rev. 2002;6(4):365–70. https://doi.org/10.1023/a:1021171922099 . - DOI - PubMed
    1. Jaïs P, Hocini M, Weerasoryia R, Macle L, Scavee C, Raybaud F, Shah DC, Clémenty J, Haïssaguerre M. Atypical left atrial flutters. Card Electrophysiol Rev. 2002;6(4):371–7. https://doi.org/10.1023/a:1021124006169 . - DOI - PubMed
    1. Chae S, Oral H, Good E, et al. Atrial tachycardia after circumferential pulmonary vein ablation of atrial !brillation: mechanistic insights, results of catheter ablation, and risk factors for recurrence. J Am Coll Cardiol. 2007;50:1781–7. https://doi.org/10.1016/j.jacc.2007.07.044 . - DOI - PubMed
    1. Fukamizu S, Sakurada H, Hayashi T, et al. Macroreentrant atrial tachycardia in patients without previous atrial surgery or catheter ablation: clinical and electrophysiological characteristics of scar- related left atrial anterior wall reentry. J Cardiovasc Electrophysiol. 2013;24:404–12. https://doi.org/10.1111/jce.12059 . - DOI - PubMed
    1. Knackstedt C, Schauerte P, Kirchhof P. Electro-anatomic mapping systems in arrhythmias. Europace. 2008;10(Suppl 3):28–34. https://doi.org/10.1093/europace/eun225 . - DOI

LinkOut - more resources