Usefulness of a crista catheter for 3-dimensional electroanatomical mapping of complex right atrial tachyarrhythmiasReport as inadecuate




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Journal of Interventional Cardiac Electrophysiology

, Volume 44, Issue 2, pp 141–149

First Online: 11 August 2015Received: 26 May 2015Accepted: 30 July 2015

Abstract

PurposeRight atrial RA tachyarrhythmias are not rare in patients with congenital heart disease and a history of cardiac surgery. This study investigated the usefulness of a crista catheter for 3-dimensional electroanatomical mapping of RA tachyarrhythmias.

MethodsWe consecutively included 35 patients age, 43.2 ± 15.6 years; 15 men who underwent an electrophysiological study with 3-dimensional electroanatomical mapping for RA tachycardia or flutter. In 13 patients with atrial flutter, we recorded and compared the electrical sequence in the anterior and posterior portions of the RA lateral wall. We used a crista catheter as a mapping catheter for 3-dimensional mapping in 12 patients crista group, a lasso catheter in 12 patients lasso group, and an ablation catheter in 11 patients ablation group. We compared the 3-dimensional mapping points, time, and speed mapping points per minute among the groups.

ResultsAtrial flutter was confirmed as cavotricuspid isthmus-dependent in all patients whose two atrial electrical sequences were the same direction and as atypical including scar-related and dual-loop in all patients whose sequences were in the opposite direction. Mapping speed in the crista group was significantly faster than in the lasso and ablation groups: median interquartile range 44.0 35.5–69.4 points-min, 23.7 17.8–29.8 points-min, and 8.2 4.8–11.0 points-min, respectively p = 0.001.

ConclusionsA crista catheter is useful for high-density 3-dimensional electroanatomical mapping of complex RA tachyarrhythmias. Comparison of the electrical sequences in the anterior and posterior portions of the RA lateral wall is helpful for differentiating between cavotricuspid isthmus-dependent and atypical atrial flutter.

KeywordsAtrial flutter Atrial tachycardia Crista catheter Right atrium Three-dimensional mapping  Download fulltext PDF



Author: Jae-Sun Uhm - Nam Kyun Kim - Hancheol Lee - Tae-Hoon Kim - Boyoung Joung - Hui-Nam Pak - Moon-Hyoung Lee

Source: https://link.springer.com/



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