Identification of regions maintaining atrial fibrillation through cycle length and cycle length gradient mapping
Abstract Background Visualizing the specific regions where atrial fibrillation (AF) is maintained is crucial for effective treatment, but it remains challenging in clinical practice. We aimed to address this challenge by developing a mapping approach focused on the cycle length (CL) and its gradient...
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| Format: | Article |
| Language: | English |
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Wiley
2024-12-01
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| Series: | Journal of Arrhythmia |
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| Online Access: | https://doi.org/10.1002/joa3.13151 |
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| author | Masafumi Shimojo Yasuya Inden Satoshi Yanagisawa Ryota Yamauchi Kei Hiramatsu Tomoya Iwawaki Masaya Tachi Shun Kondo Takayuki Goto Yukiomi Tsuji Toyoaki Murohara |
| author_facet | Masafumi Shimojo Yasuya Inden Satoshi Yanagisawa Ryota Yamauchi Kei Hiramatsu Tomoya Iwawaki Masaya Tachi Shun Kondo Takayuki Goto Yukiomi Tsuji Toyoaki Murohara |
| author_sort | Masafumi Shimojo |
| collection | DOAJ |
| description | Abstract Background Visualizing the specific regions where atrial fibrillation (AF) is maintained is crucial for effective treatment, but it remains challenging in clinical practice. We aimed to address this challenge by developing a mapping approach focused on the cycle length (CL) and its gradient (CL‐gradient). Methods In 105 patients undergoing initial ablation for persistent AF, pre‐ablation CARTOFINDER data were utilized to create maps based on three indicators: (1) CL, the atrial frequency during AF calculated using CARTOFINDER; (2) Short CL, encompassing CLs within 5 ms of the minimum CL; and (3) CL‐gradient, the CL range within a 6 mm radius. We evaluated the association between the AF termination through ablation and the measured values and patterns in each map. Results AF termination occurred in 17 patients. The AF termination group exhibited the significant large maximum CL‐gradient (48.8 ms [interquartile range, 38.6–66.3], p <.001) and the short distance between the minimum CL site and the maximum CL‐gradient site (15.8 mm, [interquartile range, 6.0–23.2], p =.029). Of the 17 AF termination cases, 13 exhibited a CL distribution pattern characterized by a steep CL‐gradient near the minimum CL site (SG‐MCL), defined as the distance of less than 23.2 mm and the maximum CL‐gradient greater than 33.1 ms. In these AF termination cases, SG‐MCL was also correlated with the ablation area. Conclusions The minimum CL area accompanied by significant CL gradients in the immediate vicinity may play a crucial role in sustaining AF. |
| format | Article |
| id | doaj-art-5ef66b2dce0643ef9b80a2377cc32f4c |
| institution | OA Journals |
| issn | 1880-4276 1883-2148 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj-art-5ef66b2dce0643ef9b80a2377cc32f4c2025-08-20T02:33:43ZengWileyJournal of Arrhythmia1880-42761883-21482024-12-014061389139910.1002/joa3.13151Identification of regions maintaining atrial fibrillation through cycle length and cycle length gradient mappingMasafumi Shimojo0Yasuya Inden1Satoshi Yanagisawa2Ryota Yamauchi3Kei Hiramatsu4Tomoya Iwawaki5Masaya Tachi6Shun Kondo7Takayuki Goto8Yukiomi Tsuji9Toyoaki Murohara10Department of Cardiovascular Research and Innovation Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Cardiology Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Cardiology Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Cardiology Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Cardiology Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Cardiology Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Cardiology Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Cardiology Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Cardiology Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Cardiovascular Research and Innovation Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Cardiology Nagoya University Graduate School of Medicine Nagoya JapanAbstract Background Visualizing the specific regions where atrial fibrillation (AF) is maintained is crucial for effective treatment, but it remains challenging in clinical practice. We aimed to address this challenge by developing a mapping approach focused on the cycle length (CL) and its gradient (CL‐gradient). Methods In 105 patients undergoing initial ablation for persistent AF, pre‐ablation CARTOFINDER data were utilized to create maps based on three indicators: (1) CL, the atrial frequency during AF calculated using CARTOFINDER; (2) Short CL, encompassing CLs within 5 ms of the minimum CL; and (3) CL‐gradient, the CL range within a 6 mm radius. We evaluated the association between the AF termination through ablation and the measured values and patterns in each map. Results AF termination occurred in 17 patients. The AF termination group exhibited the significant large maximum CL‐gradient (48.8 ms [interquartile range, 38.6–66.3], p <.001) and the short distance between the minimum CL site and the maximum CL‐gradient site (15.8 mm, [interquartile range, 6.0–23.2], p =.029). Of the 17 AF termination cases, 13 exhibited a CL distribution pattern characterized by a steep CL‐gradient near the minimum CL site (SG‐MCL), defined as the distance of less than 23.2 mm and the maximum CL‐gradient greater than 33.1 ms. In these AF termination cases, SG‐MCL was also correlated with the ablation area. Conclusions The minimum CL area accompanied by significant CL gradients in the immediate vicinity may play a crucial role in sustaining AF.https://doi.org/10.1002/joa3.13151atrial fibrillationcatheter ablationcycle lengthcycle length gradientdriver |
| spellingShingle | Masafumi Shimojo Yasuya Inden Satoshi Yanagisawa Ryota Yamauchi Kei Hiramatsu Tomoya Iwawaki Masaya Tachi Shun Kondo Takayuki Goto Yukiomi Tsuji Toyoaki Murohara Identification of regions maintaining atrial fibrillation through cycle length and cycle length gradient mapping Journal of Arrhythmia atrial fibrillation catheter ablation cycle length cycle length gradient driver |
| title | Identification of regions maintaining atrial fibrillation through cycle length and cycle length gradient mapping |
| title_full | Identification of regions maintaining atrial fibrillation through cycle length and cycle length gradient mapping |
| title_fullStr | Identification of regions maintaining atrial fibrillation through cycle length and cycle length gradient mapping |
| title_full_unstemmed | Identification of regions maintaining atrial fibrillation through cycle length and cycle length gradient mapping |
| title_short | Identification of regions maintaining atrial fibrillation through cycle length and cycle length gradient mapping |
| title_sort | identification of regions maintaining atrial fibrillation through cycle length and cycle length gradient mapping |
| topic | atrial fibrillation catheter ablation cycle length cycle length gradient driver |
| url | https://doi.org/10.1002/joa3.13151 |
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