계명대학교 의학도서관 Repository

High density mapping guided partial antral ablation for a pulmonary vein isolation

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Author(s)
Jongmin HwangSeongwook HanChun HwangHyoung-Seob ParkCheol Hyun LeeIn-Cheol KimYun-Kyeong ChoJin Wook ChungHyuck-Jun YoonHyungseop KimChang-Wook NamSeung-Ho HurJin Young KimYun Seok KimWoo Sung Jang
Keimyung Author(s)
Hwang, Jong MinHan, Seong WookPark, Hyoung SeobLee, Cheol HyunKim, In CheolCho, Yun KyeongChung, Jin-WookYoon, Hyuck JunKim, Hyung SeopNam, Chang WookHur, Seung HoKim, Jin YoungKim, Yun SeokJang, Woo Sung
Department
Dept. of Internal Medicine (내과학)
Dept. of Radiology (영상의학)
Dept. of Thoracic & Cardiovascular Surgery (흉부외과학)
Journal Title
Sci Rep
Issued Date
2021
Volume
11
Abstract
The muscular discontinuities at the pulmonary vein (PV)–left atrial (LA) junction are known. The high-density mapping may help to find the muscular discontinuity. This study evaluated the efficacy of a partial antral ablation for a pulmonary vein (PV) isolation using high density (HD) mapping. A total of 60 drug-refractory atrial fibrillation (AF) patients undergoing catheter ablation were enrolled. The detailed activation mapping of each PV and LA junction was performed using an HD mapping system, and each PV segment's activation pattern was classified into a "directly-activated from the LA" or "passively-activated from an adjacent PV segment" pattern. The antral ablations were performed at the directly-activated PV segments only when the PV had "passively-activated segments". If the PV did not contain passively-activated segments, a circumferential antral ablation was performed on those PVs. A "successful partial antral ablation" was designated if the electrical isolation of targeted PV was achieved by ablation at the directly-activated segments only. If the isolation was not achieved even though all directly-activated segments were ablated, a "failed partial antral ablation" was designated, and then a circumferential ablation was performed. Among 240 PVs, passively-activated segments were observed in 140 (58.3%) PVs. Both inferior PVs had more passively-activated segments than superior PVs, and the posteroinferior segments had the highest proportion of passive activation. The overall rate of successful partial antral ablation was 85%. The atrial tachyarrhythmia recurrence was observed in 10 patients (16.7%) at 1-year. HD mapping allowed the evaluation of the detailed activation patterns of the PVs, and passively-activated segments may represent muscular discontinuity. Partial antral ablation of directly-activated antral segments only was feasible and effective for a PVI.
Keimyung Author(s)(Kor)
황종민
한성욱
박형섭
이철현
김인철
조윤경
정진욱
윤혁준
김형섭
남창욱
허승호
김진영
김윤석
장우성
Publisher
School of Medicine (의과대학)
Citation
Jongmin Hwang et al. (2021). High density mapping guided partial antral ablation for a pulmonary vein isolation. Sci Rep, 11, 16563. doi: 10.1038/s41598-021-96004-4
Type
Article
ISSN
2045-2322
Source
https://www.nature.com/articles/s41598-021-96004-4
DOI
10.1038/s41598-021-96004-4
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43983
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
1. School of Medicine (의과대학) > Dept. of Thoracic & Cardiovascular Surgery (흉부외과학)
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