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Article10.1161/circ.124.suppl_21.a17607

Abstract 17607: Substrate Based Atrial Fibrillation Ablation Guided by Voltage Gradient Mapping: Initial Results and Near-Term Clinical Outcome

Steven Bailin,Craig J. Hoffman,Robert West-2011-11-22-Circulation
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TL;DRAbstract

Background: Ablation of atrial fibrillation (AF) is anatomic based with isolation of pulmonary veins (PVs), generally in combination with linear ablation. Because AF is chaotic, activation mapping cannot reveal underlying mechanisms or reasons for success or failure. We report substrate based ablation guided by voltage gradient mapping (VGM) provides promising initial and near-term success. Methods and Results: 55 consecutive patients undergoing AF ablation, 29 paroxysmal (PAF) and 26 chronic (CAF), had contact voltage mapping within the left and right atrium, PVs, SVC, and IVC. Adjustment of voltage levels displayed low voltage connections between higher voltage regions. Ablation of low voltage bridges (LVB) was performed until repeat maps had no demonstrable LVB. Ablation endpoints were termination of AF and failure to induce AF or tachycardia. Clinical success was defined by the absence of recurrent AF (primary endpoint), and freedom from sustained arrhythmias (secondary endpoint) d

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Background: Ablation of atrial fibrillation (AF) is anatomic based with isolation of pulmonary veins (PVs), generally in combination with linear ablation. Because AF is chaotic, activation mapping cannot reveal underlying mechanisms or reasons for success or failure. We report substrate based ablation guided by voltage gradient mapping (VGM) provides promising initial and near-term success. Methods and Results: 55 consecutive patients undergoing AF ablation, 29 paroxysmal (PAF) and 26 chronic (CAF), had contact voltage mapping within the left and right atrium, PVs, SVC, and IVC. Adjustment of voltage levels displayed low voltage connections between higher voltage regions. Ablation of low voltage bridges (LVB) was performed until repeat maps had no demonstrable LVB. Ablation endpoints were termination of AF and failure to induce AF or tachycardia. Clinical success was defined by the absence of recurrent AF (primary endpoint), and freedom from sustained arrhythmias (secondary endpoint) d

Keywords

MedicineAtrial fibrillationAblationCardiologyTerm (time)Internal medicineOutcome (game theory)

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