The isthmus characteristics of scar‐related macroreentrant atrial tachycardia in patients with and without cardiac surgery
Introduction Identifying the critical isthmus (CI) in scar‐related macroreentrant atrial tachycardia (AT) is challenging, especially for patients with cardiac surgery. We aimed to investigate the electrophysiological characteristics of scar‐related macroreentrant ATs in patients with and without car...
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| Veröffentlicht in: | Journal of cardiovascular electrophysiology 2021-07, Vol.32 (7), p.1921-1930 |
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| creator | Liu, Shin‐Huei Lin, Yenn‐Jiang Lee, Po‐Tseng Vicera, Jennifer Jeanne Chang, Shih‐Lin Lo, Li‐Wei Hu, Yu‐Feng Chung, Fa‐Po Tuan, Ta‐Chuan Chao, Tze‐Fan Liao, Jo‐Nan Chang, Ting‐Yung Lin, Chin‐Yu Wu, Cheng‐I Liu, Chih‐Min Cheng, Wen‐Han Chen, Shih‐Ann |
| description | Introduction
Identifying the critical isthmus (CI) in scar‐related macroreentrant atrial tachycardia (AT) is challenging, especially for patients with cardiac surgery. We aimed to investigate the electrophysiological characteristics of scar‐related macroreentrant ATs in patients with and without cardiac surgery.
Methods
A prospective study of 31 patients (mean age 59.4 ± 9.81 years old) with scar‐related macroreentrant ATs were enrolled for investigation of substrate properties. Patients were categorized into the nonsurgery (n = 18) and surgery group (n = 13). The CIs were defined by concealed entrainment, conduction velocity less than 0.3 m/s, and the presence of local fractionated electrograms.
Results
Among the 31 patients, a total of 65 reentrant circuits and 76 CIs were identified on the coherent map. The scar in the surgical group is larger than the nonsurgical group (18.81 ± 9.22 vs. 10.23 ± 5.34%, p = .016). The CIs in surgical group have longer CI length (15.27 ± 4.89 vs. 11.20 ± 2.96 mm, p = .004), slower conduction velocity (0.46 ± 0.19 vs. 0.69 ± 0.14 m/s, p |
| doi_str_mv | 10.1111/jce.15034 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2511239075</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2511239075</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3534-b8ae815b6cd37df0c9ac8538b9b5fd619f037ce09d5a11be5d254cb8af12b0943</originalsourceid><addsrcrecordid>eNp10ctKxDAUBuAgiveFLyABN7qoJk3Ty1IGrwhudF1Ok1OboZcxSRkGXPgIPqNPYrTqQjCbHMKXn5CfkAPOTnlYZ3OFp1wykayRbS4TFuU8zdbDzBIZiTwTW2THuTljXKRMbpItIXKRSCm3yctDg9Q433Sjo6oBC8qjDQdGOTrU1Cmw769vFlvwqGkHyg4WsfcWek_BWwMt9aCaVYDaADU9XYA3QTi6NL6h0OuvYRg9nYyibrRPaFd7ZKOG1uH-975LHi8vHmbX0d391c3s_C5SQookqnLAnMsqVVpkumaqAJVLkVdFJWud8qJmIlPICi2B8wqljmWiwq2axxUrErFLjqfchR2eR3S-7IxT2LbQ4zC6Mpacx6JgmQz06A-dD6Ptw-uCSrIiy-I0DepkUuE3nLNYlwtrOrCrkrPys5IyVFJ-VRLs4XfiWHWof-VPBwGcTWBpWlz9n1Tezi6myA8xDpis</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2547977266</pqid></control><display><type>article</type><title>The isthmus characteristics of scar‐related macroreentrant atrial tachycardia in patients with and without cardiac surgery</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Liu, Shin‐Huei ; Lin, Yenn‐Jiang ; Lee, Po‐Tseng ; Vicera, Jennifer Jeanne ; Chang, Shih‐Lin ; Lo, Li‐Wei ; Hu, Yu‐Feng ; Chung, Fa‐Po ; Tuan, Ta‐Chuan ; Chao, Tze‐Fan ; Liao, Jo‐Nan ; Chang, Ting‐Yung ; Lin, Chin‐Yu ; Wu, Cheng‐I ; Liu, Chih‐Min ; Cheng, Wen‐Han ; Chen, Shih‐Ann</creator><creatorcontrib>Liu, Shin‐Huei ; Lin, Yenn‐Jiang ; Lee, Po‐Tseng ; Vicera, Jennifer Jeanne ; Chang, Shih‐Lin ; Lo, Li‐Wei ; Hu, Yu‐Feng ; Chung, Fa‐Po ; Tuan, Ta‐Chuan ; Chao, Tze‐Fan ; Liao, Jo‐Nan ; Chang, Ting‐Yung ; Lin, Chin‐Yu ; Wu, Cheng‐I ; Liu, Chih‐Min ; Cheng, Wen‐Han ; Chen, Shih‐Ann</creatorcontrib><description>Introduction
Identifying the critical isthmus (CI) in scar‐related macroreentrant atrial tachycardia (AT) is challenging, especially for patients with cardiac surgery. We aimed to investigate the electrophysiological characteristics of scar‐related macroreentrant ATs in patients with and without cardiac surgery.
Methods
A prospective study of 31 patients (mean age 59.4 ± 9.81 years old) with scar‐related macroreentrant ATs were enrolled for investigation of substrate properties. Patients were categorized into the nonsurgery (n = 18) and surgery group (n = 13). The CIs were defined by concealed entrainment, conduction velocity less than 0.3 m/s, and the presence of local fractionated electrograms.
Results
Among the 31 patients, a total of 65 reentrant circuits and 76 CIs were identified on the coherent map. The scar in the surgical group is larger than the nonsurgical group (18.81 ± 9.22 vs. 10.23 ± 5.34%, p = .016). The CIs in surgical group have longer CI length (15.27 ± 4.89 vs. 11.20 ± 2.96 mm, p = .004), slower conduction velocity (0.46 ± 0.19 vs. 0.69 ± 0.14 m/s, p < .001), and longer total activation time (45.34 ± 9.04 vs. 38.24 ± 8.41%, p = .016) than those in the nonsurgical group. After ablation, 93.54% of patients remained in sinus rhythm during a follow‐up of 182 ± 19 days.
Conclusion
The characteristics of the isthmus in macroreentrant AT are diverse, especially for surgical scar‐related AT. The identification of CIs can facilitate the successful ablation of scar‐related ATs.</description><identifier>ISSN: 1045-3873</identifier><identifier>EISSN: 1540-8167</identifier><identifier>DOI: 10.1111/jce.15034</identifier><identifier>PMID: 33834555</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Ablation ; Cardiac arrhythmia ; Conduction ; conduction isthmus ; conduction velocity ; electroanatomical map ; Entrainment ; Heart ; Heart surgery ; scar‐related macroreentrant tachycardia ; Tachycardia ; Velocity</subject><ispartof>Journal of cardiovascular electrophysiology, 2021-07, Vol.32 (7), p.1921-1930</ispartof><rights>2021 Wiley Periodicals LLC</rights><rights>2021 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3534-b8ae815b6cd37df0c9ac8538b9b5fd619f037ce09d5a11be5d254cb8af12b0943</citedby><cites>FETCH-LOGICAL-c3534-b8ae815b6cd37df0c9ac8538b9b5fd619f037ce09d5a11be5d254cb8af12b0943</cites><orcidid>0000-0002-7461-2793 ; 0000-0002-6587-3094 ; 0000-0001-9102-227X ; 0000-0001-8395-1052 ; 0000-0001-6722-1826 ; 0000-0001-5715-2070 ; 0000-0003-0545-2156 ; 0000-0001-6026-353X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjce.15034$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjce.15034$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33834555$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Shin‐Huei</creatorcontrib><creatorcontrib>Lin, Yenn‐Jiang</creatorcontrib><creatorcontrib>Lee, Po‐Tseng</creatorcontrib><creatorcontrib>Vicera, Jennifer Jeanne</creatorcontrib><creatorcontrib>Chang, Shih‐Lin</creatorcontrib><creatorcontrib>Lo, Li‐Wei</creatorcontrib><creatorcontrib>Hu, Yu‐Feng</creatorcontrib><creatorcontrib>Chung, Fa‐Po</creatorcontrib><creatorcontrib>Tuan, Ta‐Chuan</creatorcontrib><creatorcontrib>Chao, Tze‐Fan</creatorcontrib><creatorcontrib>Liao, Jo‐Nan</creatorcontrib><creatorcontrib>Chang, Ting‐Yung</creatorcontrib><creatorcontrib>Lin, Chin‐Yu</creatorcontrib><creatorcontrib>Wu, Cheng‐I</creatorcontrib><creatorcontrib>Liu, Chih‐Min</creatorcontrib><creatorcontrib>Cheng, Wen‐Han</creatorcontrib><creatorcontrib>Chen, Shih‐Ann</creatorcontrib><title>The isthmus characteristics of scar‐related macroreentrant atrial tachycardia in patients with and without cardiac surgery</title><title>Journal of cardiovascular electrophysiology</title><addtitle>J Cardiovasc Electrophysiol</addtitle><description>Introduction
Identifying the critical isthmus (CI) in scar‐related macroreentrant atrial tachycardia (AT) is challenging, especially for patients with cardiac surgery. We aimed to investigate the electrophysiological characteristics of scar‐related macroreentrant ATs in patients with and without cardiac surgery.
Methods
A prospective study of 31 patients (mean age 59.4 ± 9.81 years old) with scar‐related macroreentrant ATs were enrolled for investigation of substrate properties. Patients were categorized into the nonsurgery (n = 18) and surgery group (n = 13). The CIs were defined by concealed entrainment, conduction velocity less than 0.3 m/s, and the presence of local fractionated electrograms.
Results
Among the 31 patients, a total of 65 reentrant circuits and 76 CIs were identified on the coherent map. The scar in the surgical group is larger than the nonsurgical group (18.81 ± 9.22 vs. 10.23 ± 5.34%, p = .016). The CIs in surgical group have longer CI length (15.27 ± 4.89 vs. 11.20 ± 2.96 mm, p = .004), slower conduction velocity (0.46 ± 0.19 vs. 0.69 ± 0.14 m/s, p < .001), and longer total activation time (45.34 ± 9.04 vs. 38.24 ± 8.41%, p = .016) than those in the nonsurgical group. After ablation, 93.54% of patients remained in sinus rhythm during a follow‐up of 182 ± 19 days.
Conclusion
The characteristics of the isthmus in macroreentrant AT are diverse, especially for surgical scar‐related AT. The identification of CIs can facilitate the successful ablation of scar‐related ATs.</description><subject>Ablation</subject><subject>Cardiac arrhythmia</subject><subject>Conduction</subject><subject>conduction isthmus</subject><subject>conduction velocity</subject><subject>electroanatomical map</subject><subject>Entrainment</subject><subject>Heart</subject><subject>Heart surgery</subject><subject>scar‐related macroreentrant tachycardia</subject><subject>Tachycardia</subject><subject>Velocity</subject><issn>1045-3873</issn><issn>1540-8167</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp10ctKxDAUBuAgiveFLyABN7qoJk3Ty1IGrwhudF1Ok1OboZcxSRkGXPgIPqNPYrTqQjCbHMKXn5CfkAPOTnlYZ3OFp1wykayRbS4TFuU8zdbDzBIZiTwTW2THuTljXKRMbpItIXKRSCm3yctDg9Q433Sjo6oBC8qjDQdGOTrU1Cmw769vFlvwqGkHyg4WsfcWek_BWwMt9aCaVYDaADU9XYA3QTi6NL6h0OuvYRg9nYyibrRPaFd7ZKOG1uH-975LHi8vHmbX0d391c3s_C5SQookqnLAnMsqVVpkumaqAJVLkVdFJWud8qJmIlPICi2B8wqljmWiwq2axxUrErFLjqfchR2eR3S-7IxT2LbQ4zC6Mpacx6JgmQz06A-dD6Ptw-uCSrIiy-I0DepkUuE3nLNYlwtrOrCrkrPys5IyVFJ-VRLs4XfiWHWof-VPBwGcTWBpWlz9n1Tezi6myA8xDpis</recordid><startdate>202107</startdate><enddate>202107</enddate><creator>Liu, Shin‐Huei</creator><creator>Lin, Yenn‐Jiang</creator><creator>Lee, Po‐Tseng</creator><creator>Vicera, Jennifer Jeanne</creator><creator>Chang, Shih‐Lin</creator><creator>Lo, Li‐Wei</creator><creator>Hu, Yu‐Feng</creator><creator>Chung, Fa‐Po</creator><creator>Tuan, Ta‐Chuan</creator><creator>Chao, Tze‐Fan</creator><creator>Liao, Jo‐Nan</creator><creator>Chang, Ting‐Yung</creator><creator>Lin, Chin‐Yu</creator><creator>Wu, Cheng‐I</creator><creator>Liu, Chih‐Min</creator><creator>Cheng, Wen‐Han</creator><creator>Chen, Shih‐Ann</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7461-2793</orcidid><orcidid>https://orcid.org/0000-0002-6587-3094</orcidid><orcidid>https://orcid.org/0000-0001-9102-227X</orcidid><orcidid>https://orcid.org/0000-0001-8395-1052</orcidid><orcidid>https://orcid.org/0000-0001-6722-1826</orcidid><orcidid>https://orcid.org/0000-0001-5715-2070</orcidid><orcidid>https://orcid.org/0000-0003-0545-2156</orcidid><orcidid>https://orcid.org/0000-0001-6026-353X</orcidid></search><sort><creationdate>202107</creationdate><title>The isthmus characteristics of scar‐related macroreentrant atrial tachycardia in patients with and without cardiac surgery</title><author>Liu, Shin‐Huei ; Lin, Yenn‐Jiang ; Lee, Po‐Tseng ; Vicera, Jennifer Jeanne ; Chang, Shih‐Lin ; Lo, Li‐Wei ; Hu, Yu‐Feng ; Chung, Fa‐Po ; Tuan, Ta‐Chuan ; Chao, Tze‐Fan ; Liao, Jo‐Nan ; Chang, Ting‐Yung ; Lin, Chin‐Yu ; Wu, Cheng‐I ; Liu, Chih‐Min ; Cheng, Wen‐Han ; Chen, Shih‐Ann</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3534-b8ae815b6cd37df0c9ac8538b9b5fd619f037ce09d5a11be5d254cb8af12b0943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Ablation</topic><topic>Cardiac arrhythmia</topic><topic>Conduction</topic><topic>conduction isthmus</topic><topic>conduction velocity</topic><topic>electroanatomical map</topic><topic>Entrainment</topic><topic>Heart</topic><topic>Heart surgery</topic><topic>scar‐related macroreentrant tachycardia</topic><topic>Tachycardia</topic><topic>Velocity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Shin‐Huei</creatorcontrib><creatorcontrib>Lin, Yenn‐Jiang</creatorcontrib><creatorcontrib>Lee, Po‐Tseng</creatorcontrib><creatorcontrib>Vicera, Jennifer Jeanne</creatorcontrib><creatorcontrib>Chang, Shih‐Lin</creatorcontrib><creatorcontrib>Lo, Li‐Wei</creatorcontrib><creatorcontrib>Hu, Yu‐Feng</creatorcontrib><creatorcontrib>Chung, Fa‐Po</creatorcontrib><creatorcontrib>Tuan, Ta‐Chuan</creatorcontrib><creatorcontrib>Chao, Tze‐Fan</creatorcontrib><creatorcontrib>Liao, Jo‐Nan</creatorcontrib><creatorcontrib>Chang, Ting‐Yung</creatorcontrib><creatorcontrib>Lin, Chin‐Yu</creatorcontrib><creatorcontrib>Wu, Cheng‐I</creatorcontrib><creatorcontrib>Liu, Chih‐Min</creatorcontrib><creatorcontrib>Cheng, Wen‐Han</creatorcontrib><creatorcontrib>Chen, Shih‐Ann</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiovascular electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Shin‐Huei</au><au>Lin, Yenn‐Jiang</au><au>Lee, Po‐Tseng</au><au>Vicera, Jennifer Jeanne</au><au>Chang, Shih‐Lin</au><au>Lo, Li‐Wei</au><au>Hu, Yu‐Feng</au><au>Chung, Fa‐Po</au><au>Tuan, Ta‐Chuan</au><au>Chao, Tze‐Fan</au><au>Liao, Jo‐Nan</au><au>Chang, Ting‐Yung</au><au>Lin, Chin‐Yu</au><au>Wu, Cheng‐I</au><au>Liu, Chih‐Min</au><au>Cheng, Wen‐Han</au><au>Chen, Shih‐Ann</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The isthmus characteristics of scar‐related macroreentrant atrial tachycardia in patients with and without cardiac surgery</atitle><jtitle>Journal of cardiovascular electrophysiology</jtitle><addtitle>J Cardiovasc Electrophysiol</addtitle><date>2021-07</date><risdate>2021</risdate><volume>32</volume><issue>7</issue><spage>1921</spage><epage>1930</epage><pages>1921-1930</pages><issn>1045-3873</issn><eissn>1540-8167</eissn><abstract>Introduction
Identifying the critical isthmus (CI) in scar‐related macroreentrant atrial tachycardia (AT) is challenging, especially for patients with cardiac surgery. We aimed to investigate the electrophysiological characteristics of scar‐related macroreentrant ATs in patients with and without cardiac surgery.
Methods
A prospective study of 31 patients (mean age 59.4 ± 9.81 years old) with scar‐related macroreentrant ATs were enrolled for investigation of substrate properties. Patients were categorized into the nonsurgery (n = 18) and surgery group (n = 13). The CIs were defined by concealed entrainment, conduction velocity less than 0.3 m/s, and the presence of local fractionated electrograms.
Results
Among the 31 patients, a total of 65 reentrant circuits and 76 CIs were identified on the coherent map. The scar in the surgical group is larger than the nonsurgical group (18.81 ± 9.22 vs. 10.23 ± 5.34%, p = .016). The CIs in surgical group have longer CI length (15.27 ± 4.89 vs. 11.20 ± 2.96 mm, p = .004), slower conduction velocity (0.46 ± 0.19 vs. 0.69 ± 0.14 m/s, p < .001), and longer total activation time (45.34 ± 9.04 vs. 38.24 ± 8.41%, p = .016) than those in the nonsurgical group. After ablation, 93.54% of patients remained in sinus rhythm during a follow‐up of 182 ± 19 days.
Conclusion
The characteristics of the isthmus in macroreentrant AT are diverse, especially for surgical scar‐related AT. The identification of CIs can facilitate the successful ablation of scar‐related ATs.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33834555</pmid><doi>10.1111/jce.15034</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7461-2793</orcidid><orcidid>https://orcid.org/0000-0002-6587-3094</orcidid><orcidid>https://orcid.org/0000-0001-9102-227X</orcidid><orcidid>https://orcid.org/0000-0001-8395-1052</orcidid><orcidid>https://orcid.org/0000-0001-6722-1826</orcidid><orcidid>https://orcid.org/0000-0001-5715-2070</orcidid><orcidid>https://orcid.org/0000-0003-0545-2156</orcidid><orcidid>https://orcid.org/0000-0001-6026-353X</orcidid></addata></record> |
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| subjects | Ablation Cardiac arrhythmia Conduction conduction isthmus conduction velocity electroanatomical map Entrainment Heart Heart surgery scar‐related macroreentrant tachycardia Tachycardia Velocity |
| title | The isthmus characteristics of scar‐related macroreentrant atrial tachycardia in patients with and without cardiac surgery |
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