Catheter Ablation -> Ventricular Arrhythmias -> Mapping & Imaging D-PO06 - Poster Session VI (ID 26) Poster

D-PO06-100 - Electrophysiological Characteristics Of Atrial Fibrillation Phenotypes Before And After Pulmonary Vein Isolation Using Charge Density Mapping (ID 1365)

Disclosure
 F. Liu: Nothing relevant to disclose.

Abstract

Background: Clinical understanding of AF remains unclear
Objective: Identify phenotypes that maintain paroxysmal and persistent AF (PAF and PerAF) and characterize their differences before and after pulmonary vein isolation (PVI)
Methods: Forty patients with AF (PAF=21, PerAF=19) were studied. Baseline and post-PVI AF maps were generated (16-s duration) and phenotypes were identified using non-contact charge-density (NCCD) mapping (Acutus Medical). All the phenotypes were visually identified, verified by intracardiac signals and categorized into three primary conduction-patterns: focal (FO); organized reentrant pattern (O); and disorganized rotational pattern (D).
Results: A total of 142 phenotypes (FO-Pattern=35, O-Pattern=44, D-Pattern=63) were identified from all 40 baseline AF maps, with O-Patterns and D-Patterns mechanistically respectively divided into two sub-types. O-Patterns were divided into macro-reentrant (MR = 17) and local-reentrant (LR = 27). D-Patterns were divided into constrained disorganized reentry (D1 = 37) and disorganized reactivation (D2 = 26). The average regional number and prevalence of D-Patterns was higher in PerAF, while O-Patterns and F-Patterns were higher in PAF. In addition to elimination of PV-related phenotypes, the overall prevalence of MR in PAF and D1 in PerAF were increased after PVI.
Conclusion: EP phenotypes differed between PAF and PerAF as well as before and after PVI. As expected, PAF was more organized than PerAF. However, PVI also led to a higher prevalence of marco-reentry in PAF and constrained disorganized reentry in PerAF. This may provide new insight for improving ablation strategies in PAF and PerAF.

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