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“Window Sliding” analysis combined with high-density and rapid electroanatomical mapping: its efficacy and the outcome of catheter ablation of atrial tachycardia

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Abstract

Atrial tachycardia (AT) is a clinically challenging arrhythmia that can occur based on atrial substrates. Nowadays, a rapid construction of three-dimensional electroanatomical maps, which has an analysis function for complex arrhythmias, named ‘Window Sliding’ (WS) is available. However, little data has revealed the efficacy of this mapping strategy. The aim of this study was to investigate the efficacy of the WS analysis for AT treatments. All patients underwent electrophysiological studies during ATs and the characteristics of the ATs were analyzed using rapid high-density mapping followed by the WS analysis. RFA was then performed. Fifty-five ATs were identified in 34 patients (63 ± 17 year-old) and in 51 activation maps (cycle length, 322 ± 120 milliseconds) were successfully constructed with 644 ± 433 points per map during 5.3 ± 2.5 min. The types of detected ATs were macro-reentries around the mitral (8) and, tricuspid (12) valves, roof-dependent reentry (5), others (13), and focal patterns (13). Of those that underwent RFA, 46 (98%) were treated successfully. Two ATs were abandoned since their critical sites were close to the His bundle and sinoatrial node. During a mean follow-up period of 179 ± 176 days, 7 patients had documented recurrences of AT. This high-density mapping using the WS analysis was useful for creating the entire picture of the ATs in a short time, resulting in favorable RFA outcomes.

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Author information

Correspondence to Koji Miyamoto or Kengo Kusano.

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The authors declare that they have no conflict of interest.

Electronic supplementary material

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Online Resource 1: The animation that shows actual ‘Window Sliding’ analysis for 3 macro-reentrant atrial tachycardia. After an acquisition of mapping points, the patterns of the color-coding on activation map can be changed by sliding the color bar. The color bar was moved until the white narrow area appeared. Some ATs had multiple narrow white areas, which meant they contained multiple slow conduction zones (MPG 5948 KB)

Online Resource 1: The animation that shows actual ‘Window Sliding’ analysis for 3 macro-reentrant atrial tachycardia. After an acquisition of mapping points, the patterns of the color-coding on activation map can be changed by sliding the color bar. The color bar was moved until the white narrow area appeared. Some ATs had multiple narrow white areas, which meant they contained multiple slow conduction zones (MPG 5948 KB)

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Nakasuka, K., Miyamoto, K., Noda, T. et al. “Window Sliding” analysis combined with high-density and rapid electroanatomical mapping: its efficacy and the outcome of catheter ablation of atrial tachycardia. Heart Vessels 32, 984–996 (2017) doi:10.1007/s00380-017-0959-6

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Keywords

  • Atrial tachycardia
  • Rapid and high-density electroanatomical mapping
  • Activation map
  • Window Sliding
  • Slow conduction zone