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 May;35(5):942-949.
doi: 10.1111/jce.16234. Epub 2024 Mar 10.

Voltage and propagation mapping: New tools to improve successful ablation of atrioventricular nodal reentry tachycardia

Affiliations

Voltage and propagation mapping: New tools to improve successful ablation of atrioventricular nodal reentry tachycardia

Chiara Devecchi et al. J Cardiovasc Electrophysiol. 2024 May.

Abstract

Introduction: Mapping system is useful in ablation of atrioventricular nodal reentry tachycardia (AVNRT) and localization of anatomic variances. Voltage mapping identifies a low voltage area in the Koch triangle called low-voltage-bridge (LVB); propagation mapping identifies the collision point (CP) of atrial wavefront convergence. We conducted a prospective study to evaluate the relationship between LVB and CP with successful site of ablation and identify standard value for LVB.

Materials and methods: Three-dimensional (3D) maps of the right atria were constructed from intracardiac recordings using the ablation catheter. Cut-off values on voltage map were adjusted until LVB was observed. On propagation map, atrial wavefronts during sinus rhythm collide in the site representing CP, indicating the area of slow pathway conduction. Ablation site was selected targeting LVB and CP site, confirmed by anatomic position on fluoroscopy and atrioventricular ratio.

Results: Twenty-seven consecutive patients were included. LVB and CP were present in all patients. Postprocedural evaluation identified standard cut-off of 0.3-1 mV useful for LVB identification. An overlap between LVB and CP was observed in 23 (85%) patients. Procedure success was achieved in all patient with effective site at first application in 22 (81%) patients. There was a significant correlation between LVB, CP, and the site of effective ablation (p = .001).

Conclusion: We found correlation between LVB and CP with the site of effective ablation, identifying a voltage range useful for standardized LVB identification. These techniques could be useful to identify ablation site and minimize radiation exposure.

Keywords: ablation; atrioventricular nodal reentry tachicardia; propagation mapping; three‐dimensional mapping; voltage mapping.

PubMed Disclaimer

References

REFERENCES

    1. Kesek M, Lindmark D, Rashid A, Jensen SM. Increased risk of late pacemaker implantation after ablation for atrioventricular nodal reentry tachycardia: a 10‐year follow‐up of a nationwide cohort. Heart Rhythm. 2019;16:1182‐1188.
    1. Riccardi R, Gaita F, Caponi D, et al. Percutaneous catheter cryothermal ablation of atrioventricular nodal re‐entrant tachycardia: efficacy and safety of a new ablation technique. Italian Heart J. 2003;4:35‐43.
    1. Insulander P, Bastani H, Braunschweig F, et al. Cryoablation of substrates adjacent to the atrioventricular node: acute and long‐term safety of 1303 ablation procedures. Europace. 2014;16:271‐276.
    1. Insulander P, Bastani H, Braunschweig F, et al. Cryoablation of atrioventricular nodal re‐entrant tachycardia: 7‐year follow‐up in 515 patients‐confirmed safety but very late recurrences occur. Europace. 2017;19(6):1038‐1042.
    1. Hanninen M, Yeung‐Lai‐Wah N, Massel D, et al. Cryoablation versus RF ablation for AVNRT: a meta‐analysis and systematic review. J Cardiovasc Electrophysiol. 2013;24:1354‐1360.

LinkOut - more resources