Journal: Europace
Article Title: Efficacy and safety of pulsed field ablation for accessory pathways: a pilot study
doi: 10.1093/europace/euae139
Figure Lengend Snippet: Successful ablation of AP at LALW. ( A ) AVRT was induced after RVA pacing. From top to bottom, the following tracings are displayed: surface ECG, CS electrograms from proximal (CS 9–10 ) to distal (CS 1–2 ), distal (HB 1–2 ), and proximal (HB 3–4 ) His bundle electrograms, distal (Bi-Abl) bipolar and unipolar (Uni-Abl) recording from the PFA catheter, and RVA electrograms. Earliest retrograde atrial activation with bipolar recording was at LALW during RVA pacing navigated by 3D electroanatomical mapping ( B , green point) and fluoroscopy ( C ), and the morphology of unipolar electrograms of ERAA was QS. Note the distinct APP inserting (orange arrow) between ERAA (black arrow) and retrograde ventricular activation (V). Successful ablation was achieved after one pulse train delivery ( D , 1-PFA modality), and three pulse train deliveries ( E , 3-PFA modality) at the same AS were applied. ( F ) Transient AV conduction block for a short period after the adenosine injection, then left ventricular pacing confirmed terminating conduction over AP. Bonus lesions (red points) were created near the target with 3-PFA modality. Sustained AP conduction termination was observed by RVA pacing. Abl, ablation catheter; AP, accessory pathway; APP, accessory pathway potential; AS, ablation site; AVRT, atrioventricular reentrant tachycardia; CS, coronary sinus; ERAA, earliest retrograde atrial activation; LALW, left anterolateral wall; LAO, left anterior oblique; LL, left lateral; MA, mitral annulus; PFA, pulsed field ablation; RAO, right anterior oblique; RVA, right ventricular apex.
Article Snippet: The image of TA or MA, HB, and CS was labelled when the PFA catheter moved along the cavity surface guided by a three-dimensional electroanatomical mapping system (3D-EAMS, ColumbusTM 3D EP Navigation system, Shanghai MicroPort EP MedTech Co., Ltd., China).
Techniques: Activation Assay, Blocking Assay, Injection