Successful modulation of atrial fibrillation drivers anchoring to fibrotic tissue after box isolation using an online real-time phase mapping system: ExTRa Mapping.
Toshihiro NakamuraKunihiko KiuchiKoji FukuzawaMitsuru TakamiTomomi AkitaHideya SuehiroMakoto TakemotoJun SakaiAtsusuke YatomiYusuke SonodaHiroyuki TakaharaKazutaka NakasoneKyoko YamamotoKen-Ichi HirataTakashi AshiharaPublished in: Journal of arrhythmia (2019)
A 41-year-old man with persistent atrial fibrillation (AF) underwent radiofrequency (RF) catheter ablation using an online real-time phase mapping system: ExTRa Mapping. Box isolation could not terminate AF. Subsequently, RF applications on nonpassively activated areas (NPAs), where rotational activations were frequently observed, at the posterior bottom of left atrium outside of box lesion could convert AF to common atrial flutter. Of interest, the NPA near the posterior bottom were located on the patchy fibrotic tissue area assessed by the late-gadolinium enhancement magnetic resonance imaging. This indicated the possibility of the critical AF rotor meandering through the fibrotic tissue area.
Keyphrases
- atrial fibrillation
- catheter ablation
- left atrial
- left atrial appendage
- high resolution
- oral anticoagulants
- magnetic resonance imaging
- direct oral anticoagulants
- high density
- systemic sclerosis
- transcription factor
- heart failure
- idiopathic pulmonary fibrosis
- percutaneous coronary intervention
- binding protein
- computed tomography
- coronary artery
- magnetic resonance
- coronary artery disease
- pulmonary arterial hypertension