Functional mapping to reveal slow conduction and substrate progression in atrial fibrillation.

Aims: The aim of our study was to analyse the response to short-coupled atrial extrastimuli to identify areas of hidden slow conduction (HSC) and their relationship with the atrial fibrillation (AF) phenotype.

Methods And Results: Twenty consecutive patients with paroxysmal AF and persistent AF (10:10) underwent the first pulmonary vein isolation procedure. Triple short-coupled extrastimuli were delivered in sinus rhythm (SR), and the evoked response was analysed: sites exhibiting double or highly fragmented electrograms (EGM) were defined as positive for HSC (HSC+).

Direct Implantation of a Left Atrial Appendage Occluder During Cardiothoracic Surgery.

Surgical suture or exclusion of the left atrial appendage (LAA) is a commonly performed technique in patients undergoing cardiothoracic revascularization or valve repair, or both. However, incomplete surgical sealing of the LAA is not a rare phenomenon and strongly increases the risk for future cerebrovascular embolic events. We report the implantation of a Watchman LAA occluder (Boston Scientific, Natick, MA) during redo minimally invasive open heart surgery.

Premature ventricular contractions cause a position shift in 3D mapping systems: analysis, quantification, and correction by hybrid activation mapping.

Aims: Using a modified CARTO 3D mapping system, we studied if premature ventricular contractions (PVCs) cause position shifts within the 3D co-ordinate system. We quantified magnitude of the phenomenon and corrected for it, by creating both an activation map that represents the conventional local activation time (LAT) and one corrected for this position shift (hybrid LAT map).

Methods And Results: We prospectively enrolled patients planned for PVC ablation.

Left atrial volume computed by 3D rotational angiography best predicts atrial fibrillation recurrence after circumferential pulmonary vein isolation.

Left atrium (LA) size is a well-studied predictor of atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). Yet, there is still little agreement on the best imaging technique to size the LA, and on the most appropriate sizing parameter. Volumetric assessment of LA with three-dimensional rotational angiography (3DRA LA volume index) might be a valid alternative to the commonly used transthoracic echocardiography (TTE LA volume index).