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dc.contributor.authorTomlinson, DR
dc.contributor.authorMyles, M
dc.contributor.authorStevens, Kara
dc.contributor.authorStreeter, Adam
dc.date.accessioned2019-07-17T10:06:55Z
dc.date.issued2019-07
dc.identifier.issn0147-8389
dc.identifier.issn1540-8159
dc.identifier.otherpace.13729
dc.identifier.urihttp://hdl.handle.net/10026.1/14649
dc.description.abstract

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>To assess occurrence of a histologically validated measure of transmural (TM) atrial ablation—pure R unipolar electrogram (UE) morphology change—at first‐ablated left atrial posterior wall (LAPW) sites during contact force (CF)‐guided pulmonary vein isolation (PVI).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Objectively annotated VISITAG™ Module and CARTOREPLAY™ (Biosense Webster Inc., Diamond Bar, CA, USA) UE morphology data were retrospectively analyzed in 23 consecutive patients undergoing PVI under general anesthesia.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>PVI without spontaneous/dormant recovery was achieved in all, employing 16.3 (3.2) min of radiofrequency (RF; 30 W) energy. All first‐ablated LAPW sites demonstrated RS UE morphology preablation, with RF‐induced pure R UE morphology change in 98%. Time to pure R UE morphology was significantly shorter at left‐sided LAPW sites (4.9 [2.1] vs 6.7 [2.5] s; <jats:italic>P</jats:italic> = .02), with significantly greater impedance drop (median 13.5 vs 9.9 Ω; <jats:italic>P</jats:italic> = .003). Importantly, neither first‐site RF duration (14.9 vs 15.0 s) nor maximum ablation catheter tip distance moved (during RF) was significantly different, yet the mean CF was significantly higher at right‐sided sites (16.5 vs 11.2 g; <jats:italic>P</jats:italic> = .002). Concurrent impedance and objectively annotated bipolar electrogram (BE) data demonstrated ∼6‐8 Ω impedance drop and ∼30% BE decrease at the time of first pure R UE morphology change.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Using objective ablation site annotation, UE morphology evidence of TM RF effect was demonstrated far sooner than considered biologically possible according to the “conventional” 20‐40 s RF per‐site approach, with significantly greater ablative effect evident at left‐sided sites. This novel methodology represents a scientifically more rigorous foundation toward future research into the biological effects of RF ablation in vivo.</jats:p></jats:sec>

dc.format.extent922-929
dc.format.mediumPrint-Electronic
dc.languageen
dc.language.isoen
dc.publisherWiley
dc.subjectatrial fibrillation
dc.subjectcontact force catheter ablation
dc.subjectpulmonary vein isolation
dc.subjectunipolar electrogram
dc.subjectVISITAG (TM) Module
dc.titleTransmural unipolar electrogram change occurs within 7s at the left atrial posterior wall during pulmonary vein isolation
dc.typejournal-article
dc.typeJournal Article
plymouth.author-urlhttps://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000474649700020&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008
plymouth.issue7
plymouth.volume42
plymouth.publication-statusPublished
plymouth.journalPacing and Clinical Electrophysiology
dc.identifier.doi10.1111/pace.13729
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Institute of Health and Community
plymouth.organisational-group/Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR)
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dc.publisher.placeUnited States
dcterms.dateAccepted2019-05-16
dc.rights.embargodate2020-5-23
dc.identifier.eissn1540-8159
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1111/pace.13729
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2019-07
rioxxterms.typeJournal Article/Review


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