Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Shah, AJ; Pascale, P; Miyazaki, S; Liu, X; Roten, L; Derval, N; Jadidi, AS; Scherr, D; Wilton, SB; Pedersen, M; Knecht, S; Sacher, F; Jaïs, P; Haïssaguerre, M; Hocini, M.
Prevalence and types of pitfall in the assessment of mitral isthmus linear conduction block.
Circ Arrhythm Electrophysiol. 2012; 5(5):957-967
Doi: 10.1161/CIRCEP.112.971259
[OPEN ACCESS]
Web of Science
PubMed
FullText
FullText_MUG
- Co-authors Med Uni Graz
- Scherr Daniel
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- To identify and understand clinically encountered pitfalls in the assessment of transmitral conduction block using differential coronary sinus and left atrial appendage pacing techniques in patients with left mitral isthmus linear ablation. All the available assessments of mitral isthmus block were thoroughly reviewed in 271 mitral isthmus ablation procedures undertaken among 236 patients from October 2008 to April 2011. Bidirectional block was established in 186 of 271 (69%) procedures. Careful evaluation of electrograms recorded on the multipolar coronary sinus and ablation catheters was undertaken to identify and understand the characteristics of pitfall, if any. Pitfall was encountered in 55 of 271 (20%) procedures among 51 patients and categorized into 6 types (types 1, 3, 4, and 5 led to spurious diagnosis of block; types 2 and 6 led to erroneous diagnosis of absence of block). There were 14, 10, 17, 2, 15, and 3 (total=61) cases of pitfall types 1 through 6, respectively. Operator recognized 42 of 61 (69%) pitfalls intraprocedurally. Recognition of types 1 and 5 was difficult because of indiscernible electrograms at usual amplifier settings or presence of slow conduction mimicking block. Every fifth assessment of bidirectional block across mitral isthmus linear lesion using differential coronary sinus and left atrial appendage pacing techniques encounters a pitfall, which can lead to erroneous clinical diagnosis of block or absence of block. Recognition of pitfall during the procedure is feasible and necessitates careful distinction of far-field left atrium from the local coronary sinus electrograms besides appropriate adjustments in catheter position and pacing outputs.
- Find related publications in this database (using NLM MeSH Indexing)
- Atrial Appendage - physiopathology
- Atrial Appendage - surgery
- Atrial Fibrillation - physiopathology
- Atrial Fibrillation - surgery
- Atrioventricular Block - physiopathology
- Atrioventricular Block - surgery
- Cardiac Pacing, Artificial - methods
- Catheter Ablation - methods
- Chi-Square Distribution -
- Electrocardiography -
- Electrophysiologic Techniques, Cardiac -
- Female -
- Heart Conduction System - physiopathology
- Heart Conduction System - surgery
- Humans -
- Male -
- Mitral Valve - physiopathology
- Mitral Valve - surgery
- Prevalence -
- Retrospective Studies -
- Find related publications in this database (Keywords)
- bidirectional block
- differential pacing
- linear ablation
- mitral isthmus
- pitfall