Skip to Main content Skip to Navigation
Journal articles

Value of entrainment mapping in determining the isthmus-dependent nature of atrial flutter in the presence of amiodarone.

Abstract : INTRODUCTION: Entrainment mapping is a useful procedure for localizing macroreentrant tachycardia circuits. In patients with isthmus-dependent atrial flutter, entrainment mapping from the isthmus during tachycardia results in postpacing intervals (PPI) close to the tachycardia cycle length (TCL). However, the influence of antiarrhythmic drugs on the method's value is not clearly established. The aim of our study was to assess the value of entrainment mapping in the presence of amiodarone in patients undergoing radiofrequency ablation (RFA) of isthmus-dependent atrial flutter. METHODS AND RESULTS: The study consisted of 83 patients with isthmus-dependent atrial flutter: 52 were taking amiodarone at the time of RFA (group 1) and 31 were in a drug-free state (group 2). Entrainment mapping was performed from the cavotricuspid isthmus, and PPI minus TCL was determined. The two groups had similar baseline clinical characteristics. In all patients, RFA of the isthmus resulted in termination of tachycardia, confirming the isthmus-dependent nature of the flutter. TCL was significantly longer in group 1 than in group 2 (263 +/- 31 msec vs 238 +/- 27 msec, P < 0.0002). PPI minus TCL at the isthmus was significantly longer in group 1 than in group 2 (17 +/- 17 msec vs 8 +/- 4 msec, P < 0.01). More patients in group 1 had PPI-TCL>20 msec compared to group 2 (37% vs 10%, P = 0.01). CONCLUSION: Amiodarone significantly alters the entrainment mapping response from the isthmus. In this setting, long return cycles exceeding the TCL by >20 msec do not exclude isthmus-dependent atrial flutter.
Complete list of metadata

https://hal.univ-brest.fr/hal-00750433
Contributor : François Guerrero Connect in order to contact the contributor
Submitted on : Friday, November 9, 2012 - 11:04:25 PM
Last modification on : Monday, October 11, 2021 - 2:22:31 PM

Links full text

Identifiers

Collections

`

Citation

Marjaneh Fatemi, Jacques Mansourati, Radu Rosu, Jean-Jacques Blanc. Value of entrainment mapping in determining the isthmus-dependent nature of atrial flutter in the presence of amiodarone.. Journal of Cardiovascular Electrophysiology, Wiley, 2004, 15 (12), pp.1409-15. ⟨10.1046/j.1540-8167.2004.04278.x⟩. ⟨hal-00750433⟩

Share

Metrics

Record views

172