PMID- 35524404
OWN - NLM
STAT- MEDLINE
DCOM- 20220712
LR  - 20220804
IS  - 1540-8167 (Electronic)
IS  - 1045-3873 (Linking)
VI  - 33
IP  - 7
DP  - 2022 Jul
TI  - Targeted ablation of residual pulmonary vein potentials in atrial fibrillation 
      ablation through ultra-high-density mapping: Insights from the CHARISMA registry.
PG  - 1414-1424
LID - 10.1111/jce.15527 [doi]
AB  - INTRODUCTION: Low-voltage activity beyond pulmonary veins (PVs) may contribute to 
      the failure of ablation of atrial fibrillation (AF) in the long term. We aimed to 
      assess the presence of gaps (PVG) and residual potential (residual antral 
      potential [RAP]) within the antral scar by means of an ultra-high-density mapping 
      (UHDM) system. METHODS: We studied consecutive patients from the CHARISMA 
      registry who were undergoing AF ablation and had complete characterization of 
      residual PV antral activity. The Lumipoint (Boston Scientific) map-analysis tool 
      was used sequentially on each PV component. The ablation endpoint was PV 
      isolation (PVI) and electrical quiescence in the antral region. RESULTS: 
      Fifty-eight cases of AF ablation were analyzed. A total of 86 PVGs in 34 (58.6%) 
      patients and 44 RAPs in 34 patients (58.6%) were found. In 16 (27.6%) cases, we 
      found at least one RAP in patients with complete absence of PV conduction. RAPs 
      showed a lower mean voltage than PVG (0.3 +/- 0.2 mV vs. 0.7 +/- 0.5 mV, p < .0001), 
      whereas the mean number of electrogram peaks was higher (8.4 +/- 1.4 vs. 3.2 +/- 1.5, 
      p < .0001). The percentage of patients in whom RAPs were detected through 
      Lumipoint was higher than through propagation map analysis (58.6% vs. 36.2%, 
      p = .025). Acute procedural success was 100%, with all PVs successfully isolated 
      and RAPs completely abolished in all study patients. During a mean follow-up of 
      453 +/- 133 days, 6 patients (10.3%) suffered an AF/AT recurrence. CONCLUSION: 
      Local vulnerabilities in antral lesion sets were easily discernible by means of 
      the UHDM system in both de novo and redo patients when no PV conduction was 
      present.
CI  - (c) 2022 Wiley Periodicals LLC.
FAU - Solimene, Francesco
AU  - Solimene F
AD  - Laboratorio di Elettrofisiologia, Clinica Montevergine, Mercogliano, Avellino, 
      Italy.
FAU - Stabile, Giuseppe
AU  - Stabile G
AUID- ORCID: 0000-0003-4646-0865
AD  - Laboratorio di Elettrofisiologia, Clinica Montevergine, Mercogliano, Avellino, 
      Italy.
AD  - Laboratorio di Elettrofisiologia, Anthea Hospital, Bari, Italy.
FAU - Segreti, Luca
AU  - Segreti L
AUID- ORCID: 0000-0002-1421-9033
AD  - Second Division of Cardiology, Cardiac-Thoracic-Vascular Department, New Santa 
      Chiara Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
FAU - Malacrida, Maurizio
AU  - Malacrida M
AUID- ORCID: 0000-0001-8823-0334
AD  - Boston Scientific, Milan, Italy.
AD  - Arrhythmology Unit, Ospedale San Giovanni Calibita, Fatebefratelli, Isola 
      Tiberina, Rome, Italy.
FAU - Schillaci, Vincenzo
AU  - Schillaci V
AD  - Laboratorio di Elettrofisiologia, Clinica Montevergine, Mercogliano, Avellino, 
      Italy.
FAU - Rossi, Pietro
AU  - Rossi P
AD  - Laboratorio di Elettrofisiologia, Clinica San Michele, Maddaloni, Caserta, Italy.
FAU - Bongiorni, Maria Grazia
AU  - Bongiorni MG
AD  - Second Division of Cardiology, Cardiac-Thoracic-Vascular Department, New Santa 
      Chiara Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
FAU - Shopova, Gergana
AU  - Shopova G
AD  - Laboratorio di Elettrofisiologia, Clinica Montevergine, Mercogliano, Avellino, 
      Italy.
FAU - Cauti, Filippo Maria
AU  - Cauti FM
AD  - Laboratorio di Elettrofisiologia, Clinica San Michele, Maddaloni, Caserta, Italy.
FAU - Zucchelli, Giulio
AU  - Zucchelli G
AD  - Second Division of Cardiology, Cardiac-Thoracic-Vascular Department, New Santa 
      Chiara Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
FAU - Arestia, Alberto
AU  - Arestia A
AD  - Laboratorio di Elettrofisiologia, Clinica Montevergine, Mercogliano, Avellino, 
      Italy.
FAU - Bianchi, Stefano
AU  - Bianchi S
AD  - Laboratorio di Elettrofisiologia, Clinica San Michele, Maddaloni, Caserta, Italy.
FAU - Di Cori, Andrea
AU  - Di Cori A
AD  - Second Division of Cardiology, Cardiac-Thoracic-Vascular Department, New Santa 
      Chiara Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
FAU - Maddaluno, Francesco
AU  - Maddaluno F
AD  - Boston Scientific, Milan, Italy.
AD  - Arrhythmology Unit, Ospedale San Giovanni Calibita, Fatebefratelli, Isola 
      Tiberina, Rome, Italy.
FAU - De Simone, Antonio
AU  - De Simone A
AUID- ORCID: 0000-0002-3864-0375
AD  - Laboratorio di Elettrofisiologia, Clinica San Michele, Maddaloni, Caserta, Italy.
FAU - Garcia-Bolao, Ignacio
AU  - Garcia-Bolao I
AD  - Department of Cardiology and Cardiovascular Surgery, Clinica Universidad de 
      Navarra, Pamplona, Spain.
AD  - IdiSNA, Navarra Institute for Health Research, Navarra, Spain.
LA  - eng
SI  - ClinicalTrials.gov/NCT03793998
PT  - Journal Article
DEP - 20220601
PL  - United States
TA  - J Cardiovasc Electrophysiol
JT  - Journal of cardiovascular electrophysiology
JID - 9010756
SB  - IM
MH  - *Atrial Fibrillation/diagnosis/surgery
MH  - *Catheter Ablation/adverse effects
MH  - Humans
MH  - *Pulmonary Veins/surgery
MH  - Recurrence
MH  - Registries
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Lumipoint
OT  - atrial fibrillation
OT  - catheter ablation
OT  - electroanatomic mapping
OT  - high density
OT  - low voltage
EDAT- 2022/05/08 06:00
MHDA- 2022/07/14 06:00
CRDT- 2022/05/07 01:42
PHST- 2022/04/02 00:00 [revised]
PHST- 2021/09/07 00:00 [received]
PHST- 2022/05/04 00:00 [accepted]
PHST- 2022/05/08 06:00 [pubmed]
PHST- 2022/07/14 06:00 [medline]
PHST- 2022/05/07 01:42 [entrez]
AID - 10.1111/jce.15527 [doi]
PST - ppublish
SO  - J Cardiovasc Electrophysiol. 2022 Jul;33(7):1414-1424. doi: 10.1111/jce.15527. 
      Epub 2022 Jun 1.