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Evaluation of arrhythmogenic foci using a novel automated detection algorithm and isoproterenol in persistent atrial fibrillation

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

The CARTOFINDER mapping system analyzes activation patterns using unipolar potentials during atrial fibrillation (AF), where isoproterenol (ISP) is conventionally used to induce non-pulmonary vein (PV) foci and confirm PV arrhythmogenicity. In 20 patients with persistent AF who underwent ablation at our hospital, arrhythmogenic foci were evaluated using both these methods.

Methods

Before pulmonary vein isolation (PVI), PV and left atrium (LA) were analyzed during AF using CARTOFINDER, and the isolation line was determined based on the results. After PVI, ISP was loaded after return of sinus rhythm and confirmation of the presence of arrhythmogenic foci. The activation site in LA was ablated at the discretion of the surgeon.

Results

Focal activation sites detected by CARTOFINDER correlated with the arrhythmogenic foci induced by ISP in the PVs. The results also showed that a greater number of focal activation sites in the PVs correlated to an increased response to ISP administration. In one patient, it was observed that the focal activation site identified in the PV also coincided with the site of the origin of automaticity induced by ISP after PVI.

Conclusion

CARTOFINDER and ISP both reliably determined the presence of arrhythmogenic foci in PV, in patients with persistent AF. Knowledge of the nature of arrhythmogenic foci in non-PV is considered to be a topic for future studies, and further data collection is required.

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Data availability

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Acknowledgements

We gratefully acknowledge the contributions of the co-medical staff working on our ablation team.

Author information

Authors and Affiliations

  1. Department of Cardiology, Tosei General Hospital, 160 Nishi-Oiwake-cho, Seto-city, Aichi, 489-8642, Japan

    Yusuke Sakamoto, Hiroyuki Osanai, Shotaro Hiramatsu, Shun Kondo, Takahiro Kanbara, Yoshihito Nakashima, Hiroshi Asano & Masayoshi Ajioka

Authors
  1. Yusuke Sakamoto
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  2. Hiroyuki Osanai
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  3. Shotaro Hiramatsu
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  4. Shun Kondo
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  5. Takahiro Kanbara
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  6. Yoshihito Nakashima
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  7. Hiroshi Asano
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  8. Masayoshi Ajioka
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Contributions

Yusuke Sakamoto: conception and design of study, acquisition of data, analysis and interpretation of data, and manuscript drafting

Hiroyuki Osanai: conception and design of study, technical help, writing and editing assistance

Shotaro Hiramatsu: technical help, writing and editing assistance

Shun Kondo: technical help, writing and editing assistance

Takahiro Kanbara: technical help, writing and editing assistance

Yoshihito Nakashima: technical help, writing and editing assistance

Hiroshi Asano: technical help, writing and editing assistance

Masayoshi Ajioka: technical help, writing and editing assistance

Corresponding author

Correspondence to Yusuke Sakamoto.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of the Tosei General Hospital (No. 954).

Consent to participate

All patients provided written informed consent.

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All patients provided written informed consent.

Conflict of interest

The authors declare no competing interests.

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Cite this article

Sakamoto, Y., Osanai, H., Hiramatsu, S. et al. Evaluation of arrhythmogenic foci using a novel automated detection algorithm and isoproterenol in persistent atrial fibrillation. J Interv Card Electrophysiol 65, 63–71 (2022). https://doi.org/10.1007/s10840-022-01124-0

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  • DOI: https://doi.org/10.1007/s10840-022-01124-0

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