High-density mapping of de novo focal atrial tachycardias using a new software: Protected low-voltage areas by zones of conduction delay

Konstantinos P Letsas; Michael Efremidis; George Bazoukis; Stylianos Dragasis; Athanasia Megarisiotou; Panagiotis Mililis; Athanasios Saplaouras; Konstantinos Vlachos; Dimitrios Asvestas; Kosmas Valkanas; Gary Tse; Antonios Sideris

doi:10.1002/joa3.12380

High-density mapping of de novo focal atrial tachycardias using a new software: Protected low-voltage areas by zones of conduction delay

J Arrhythm. 2020 Jun 14;36(4):785-788. doi: 10.1002/joa3.12380. eCollection 2020 Aug.

Affiliations

¹ Second Department of Cardiology Laboratory of Cardiac Electrophysiology "Evangelismos" General Hospital of Athens Athens Greece.
² Xiamen Cardiovascular Hospital Xiamen University Xiamen P.R. China.

Abstract

Background: The pathophysiological mechanism of focal atrial tachycardias (AT) remains obscure.

Methods: Fifteen patients (6 males, age 45 ± 18) with focal AT underwent high-density activation mapping using a new software called extended early-meets-late (EEML).

Results: Irrespective of the arrhythmia mechanism, low bipolar voltage fractionated signals (0.14 ± 0.10 mV) were seen at the earliest activation site. The mean low-voltage area (LVA) at the earliest activation site was 3.2 ± 1.0 cm². EEML mapping revealed zones of conduction delay at the borders of LVAs.

Conclusions: LVAs protected by zones of slow conduction appears to play an important role in the initiation and maintenance of focal ATs.

Keywords: ablation; electroanatomical mapping; focal atrial tachycardia.