Usefulness of entrainment mapping using the activation sequence of the last captured excitation in complex dual-loop atrial tachycardia

Journal of Arrhythmia
Akira FujikiMasao Sakabe

Abstract

Electroanatomical mapping is useful for locating the atrial reentrant circuit, but analysis of the dynamic relation of the reentrant circuit is sometimes difficult. This article describes three cases of complex dual-loop reentrant atrial tachycardia analyzed by entrainment mapping using not only the postpacing interval (PPI) but also the activation sequence of the last captured beats. Case 1 was dual-loop reentry consisting of the tricuspid annulus (TA) and a localized atrial reentry at the coronary sinus (CS) ostium with different exit sites to the right and the left atrium that was cured by catheter ablation at the CS ostium showing fractionated potential. Case 2 was dual-loop reentry around the TA and the superior trans-septal incision line. Case 3 was dual-loop reentry around the TA and longitudinal dissociation along the cavo-tricuspid isthmus. In Cases 1 and 2, entrainment with a shorter pacing cycle length demonstrated antidromic penetration to the circuit and changed the activation sequence of the last captured beat depending on the anatomical relation of the reentrant circuit. In Cases 1-3 with dual-loop reentry, the excitation wavefront induced by stimulation entered one circuit after going around the other; thus, the...Continue Reading

References

Feb 15, 2000·Circulation·D ShahM Haïssaguerre
Oct 17, 2002·Journal of Cardiovascular Electrophysiology·Demosthenes KatritsisA John Camm
Jun 4, 2004·Journal of Cardiovascular Electrophysiology·Akira FujikiHiroshi Inoue
Aug 18, 2005·Pacing and Clinical Electrophysiology : PACE·Yanfei YangMelvin M Scheinman
Aug 4, 2006·Pacing and Clinical Electrophysiology : PACE·Peter LukacPeter S Hansen
Nov 3, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Peter A SantucciNeil Brysiewicz
Sep 4, 2010·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Joelci TonetFrançoise Hidden-Lucet
Oct 18, 2012·Circulation. Arrhythmia and Electrophysiology·Kelvin C K WongTimothy R Betts
Mar 27, 2013·Journal of Cardiovascular Electrophysiology·Nick W F LintonPierre Jaïs

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Citations

Aug 7, 2018·Journal of Cardiovascular Electrophysiology·Antonio De SistiManuel Font

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