Journal of Arrhythmia (Oct 2019)

Successful modulation of atrial fibrillation drivers anchoring to fibrotic tissue after box isolation using an online real‐time phase mapping system: ExTRa Mapping

  • Toshihiro Nakamura,
  • Kunihiko Kiuchi,
  • Koji Fukuzawa,
  • Mitsuru Takami,
  • Tomomi Akita,
  • Hideya Suehiro,
  • Makoto Takemoto,
  • Jun Sakai,
  • Atsusuke Yatomi,
  • Yusuke Sonoda,
  • Hiroyuki Takahara,
  • Kazutaka Nakasone,
  • Kyoko Yamamoto,
  • Ken‐ichi Hirata,
  • Takashi Ashihara

DOI
https://doi.org/10.1002/joa3.12232
Journal volume & issue
Vol. 35, no. 5
pp. 733 – 736

Abstract

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Abstract A 41‐year‐old man with persistent atrial fibrillation (AF) underwent radiofrequency (RF) catheter ablation using an online real‐time phase mapping system: ExTRa Mapping. Box isolation could not terminate AF. Subsequently, RF applications on nonpassively activated areas (NPAs), where rotational activations were frequently observed, at the posterior bottom of left atrium outside of box lesion could convert AF to common atrial flutter. Of interest, the NPA near the posterior bottom were located on the patchy fibrotic tissue area assessed by the late‐gadolinium enhancement magnetic resonance imaging. This indicated the possibility of the critical AF rotor meandering through the fibrotic tissue area.

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