Impact of High‐Density Mapping on Pulmonary Vein Isolation Durability: A Randomized, Single‐Center Study.
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| Title: | Impact of High‐Density Mapping on Pulmonary Vein Isolation Durability: A Randomized, Single‐Center Study. |
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| Authors: | Kajdič, Nina1,2 nina.kajdic@kclj.si, Kalinšek, Tine Prolič3, Antolič, Bor2, Žižek, David1,2, Štublar, Jernej2,3, Demšar, Jure4,5, Kuhelj, Dimitrij6, Jan, Matevž3 |
| Source: | Pacing & Clinical Electrophysiology. Jun2025, Vol. 48 Issue 6, p587-597. 11p. |
| Subjects: | Body surface mapping, Statistical sampling, Treatment effectiveness, Randomized controlled trials, Descriptive statistics, Arrhythmia, Atrial fibrillation, Catheter ablation, Disease relapse, Electrophysiology |
| Abstract: | Background: Despite technical progress and novel ablation strategies, pulmonary vein (PV) reconnection still occurs in a substantial proportion of patients. The aim of the study was to determine the impact of the elimination of antral low‐voltage, fragmented electrograms (LFEGMs) identified by high‐density (HD) mapping on the rate of pulmonary vein isolation (PVI) durability. Methods: Sixty patients with paroxysmal atrial fibrillation (PAF) were randomly assigned to a verification of PV entrance block and presence of LFEGMs on antral isolation lines with an HD mapping catheter (HD group) or to a verification of PV entrance block with a circumferential mapping catheter alone (CM group). In the HD group, LFEGMs were additionally ablated. Mandatory reassessment procedure to assess PVI durability and the presence of LFEGMs was performed 12 months after the index procedure or earlier in case of arrhythmia recurrence. Results: A total of 107 out of 116 (92.2%) PVs were found durably isolated in the HD group, and 97 out of 120 (80.8%) PVs in the CM group (p = 0.02). At the reassessment procedure, a total of 7 [3, 12] and 34 [24, 44] LFEGMs were found in the HD and CM groups, respectively (p = 0.00002). Elimination of LFEGMs at the index procedure reduced the likelihood of antral conduction gaps in the same segments at the reassessment. Arrhythmia recurrence rate was similar between the HD and the CM group (7/29, 24.1% vs. 10/30, 33.3%), p = 0.62, respectively. Conclusion: Additional elimination of LFEGMs identified by HD mapping of antral isolation lines after PVI resulted in a significantly higher rate of PVI durability. Trial Registration: ClinicalTrials.gov identifier: (NCT04466358) [ABSTRACT FROM AUTHOR] |
| Copyright of Pacing & Clinical Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
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| Header | DbId: egs DbLabel: Engineering Source An: 186459913 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Impact of High‐Density Mapping on Pulmonary Vein Isolation Durability: A Randomized, Single‐Center Study. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Kajdič%2C+Nina%22">Kajdič, Nina</searchLink><relatesTo>1,2</relatesTo><i> nina.kajdic@kclj.si</i><br /><searchLink fieldCode="AR" term="%22Kalinšek%2C+Tine+Prolič%22">Kalinšek, Tine Prolič</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Antolič%2C+Bor%22">Antolič, Bor</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Žižek%2C+David%22">Žižek, David</searchLink><relatesTo>1,2</relatesTo><br /><searchLink fieldCode="AR" term="%22Štublar%2C+Jernej%22">Štublar, Jernej</searchLink><relatesTo>2,3</relatesTo><br /><searchLink fieldCode="AR" term="%22Demšar%2C+Jure%22">Demšar, Jure</searchLink><relatesTo>4,5</relatesTo><br /><searchLink fieldCode="AR" term="%22Kuhelj%2C+Dimitrij%22">Kuhelj, Dimitrij</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22Jan%2C+Matevž%22">Jan, Matevž</searchLink><relatesTo>3</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Pacing+%26+Clinical+Electrophysiology%22">Pacing & Clinical Electrophysiology</searchLink>. Jun2025, Vol. 48 Issue 6, p587-597. 11p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Body+surface+mapping%22">Body surface mapping</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+sampling%22">Statistical sampling</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Randomized+controlled+trials%22">Randomized controlled trials</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Arrhythmia%22">Arrhythmia</searchLink><br /><searchLink fieldCode="DE" term="%22Atrial+fibrillation%22">Atrial fibrillation</searchLink><br /><searchLink fieldCode="DE" term="%22Catheter+ablation%22">Catheter ablation</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+relapse%22">Disease relapse</searchLink><br /><searchLink fieldCode="DE" term="%22Electrophysiology%22">Electrophysiology</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background: Despite technical progress and novel ablation strategies, pulmonary vein (PV) reconnection still occurs in a substantial proportion of patients. The aim of the study was to determine the impact of the elimination of antral low‐voltage, fragmented electrograms (LFEGMs) identified by high‐density (HD) mapping on the rate of pulmonary vein isolation (PVI) durability. Methods: Sixty patients with paroxysmal atrial fibrillation (PAF) were randomly assigned to a verification of PV entrance block and presence of LFEGMs on antral isolation lines with an HD mapping catheter (HD group) or to a verification of PV entrance block with a circumferential mapping catheter alone (CM group). In the HD group, LFEGMs were additionally ablated. Mandatory reassessment procedure to assess PVI durability and the presence of LFEGMs was performed 12 months after the index procedure or earlier in case of arrhythmia recurrence. Results: A total of 107 out of 116 (92.2%) PVs were found durably isolated in the HD group, and 97 out of 120 (80.8%) PVs in the CM group (p = 0.02). At the reassessment procedure, a total of 7 [3, 12] and 34 [24, 44] LFEGMs were found in the HD and CM groups, respectively (p = 0.00002). Elimination of LFEGMs at the index procedure reduced the likelihood of antral conduction gaps in the same segments at the reassessment. Arrhythmia recurrence rate was similar between the HD and the CM group (7/29, 24.1% vs. 10/30, 33.3%), p = 0.62, respectively. Conclusion: Additional elimination of LFEGMs identified by HD mapping of antral isolation lines after PVI resulted in a significantly higher rate of PVI durability. Trial Registration: ClinicalTrials.gov identifier: (NCT04466358) [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Pacing & Clinical Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=egs&AN=186459913 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/pace.15196 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 11 StartPage: 587 Subjects: – SubjectFull: Body surface mapping Type: general – SubjectFull: Statistical sampling Type: general – SubjectFull: Treatment effectiveness Type: general – SubjectFull: Randomized controlled trials Type: general – SubjectFull: Descriptive statistics Type: general – SubjectFull: Arrhythmia Type: general – SubjectFull: Atrial fibrillation Type: general – SubjectFull: Catheter ablation Type: general – SubjectFull: Disease relapse Type: general – SubjectFull: Electrophysiology Type: general Titles: – TitleFull: Impact of High‐Density Mapping on Pulmonary Vein Isolation Durability: A Randomized, Single‐Center Study. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Kajdič, Nina – PersonEntity: Name: NameFull: Kalinšek, Tine Prolič – PersonEntity: Name: NameFull: Antolič, Bor – PersonEntity: Name: NameFull: Žižek, David – PersonEntity: Name: NameFull: Štublar, Jernej – PersonEntity: Name: NameFull: Demšar, Jure – PersonEntity: Name: NameFull: Kuhelj, Dimitrij – PersonEntity: Name: NameFull: Jan, Matevž IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 06 Text: Jun2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 01478389 Numbering: – Type: volume Value: 48 – Type: issue Value: 6 Titles: – TitleFull: Pacing & Clinical Electrophysiology Type: main |
| ResultId | 1 |
