Publications by authors named "Jamie Shein"
Article Synopsis
- Noninvasive electroanatomic mapping (NIEAM) is a method used to identify where in the heart certain arrhythmias come from, but it's not yet proven to accurately pinpoint the exact site of origin (SOO).
- A study involving 40 patients undergoing heart procedures revealed that evaluating the direction and timing of signals in the heart using NIEAM was not very effective at predicting the SOO, performing worse than traditional ECG analysis.
- The researchers suggest a new approach where the initial step is to determine the chamber of origin (COO) and then focus on the specific site with the most negative signal amplitude to better identify the true SOO for better accuracy.
Objective: Ablation for atrial fibrillation (AF) requires electrical isolation of the pulmonary veins (PV) by wide-area circumferential PV antral isolation (PVAI). Cryoballoon ablation delivers cryoenergy circumferentially after occlusion of the PV by the cryoballoon; thus, it is likely that the level of isolation, determined by adequate balloon-tissue contact, depends on PV anatomy. We sought to examine the need for nonocclusive segmental cryoballoon ablation in achieving antral isolation, describe methods of accurate visualization of the cryoballoon using intracardiac echocardiography (ICE), and provide data on biophysical characteristics of an effective nonocclusive cryothermal lesion.
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- The study investigates the use of non-invasive electroanatomic mapping (NIEAM) to accurately identify the origins of ventricular premature depolarizations (VPDs) from different sites in the heart: the septal anterior right ventricular outflow tract (sRVOT), left coronary cusp (LCC), and distal great cardiac vein (dGCV).
- It compares NIEAM's effectiveness against traditional ECG evaluations, finding NIEAM to be superior with high sensitivity (96.9%) and specificity (98.4%) in predicting the VPD source.
- The results suggest that adopting NIEAM could significantly reduce unnecessary mapping and ablation time, ultimately enhancing the efficiency of VPD treatment.
A 48-year-old woman with paroxysmal atrial fibrillation (AF) underwent an electrophysiology study after 2 previous failed ablations. Noninvasive mapping suggested AF initiation from the right atrial appendage (RAA) with rotational drivers of AF in the RAA. Invasive mapping confirmed these findings.
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