This study uses two AcQMap imaging and electroanatomical mapping systems (Acutus Medical) to simultaneously visualise and map patterns of wavefront propagation in both the left and right atria during atrial fibrillation in order to identify mechanisms of rhythm propagation and maintenance and the importance of the interaction of the left and right atria. Mapping will also be performed during pacing from different sites and cycle lengths to identify regions of abnormal conduction that may be related to the maintenance of atrial fibrillation.
Patients undergoing first time catheter ablation for atrial fibrillation with undergo simultaneous bi-atrial mapping using two linked AcQMap imaging and mapping systems from Acutus Medical. Mapping will be performed during AF, sinus rhythm and pacing (following cardioversion if required). Pacing will be undertaken from 3 sites in order to create different vectors of conduction and at varying cycle lengths and coupling intervals in order to identify regions of slow and anisotropic conduction. Patients will then undergo pulmonary vein isolation by radiofrequency ablation followed by ablation of non-pulmonary vein targets at the operators discretion (ablation in line with clinical practice and not as part of the study). Regions of focal firing, rotational or slow conduction during AF will be noted and the interaction between each atria described.
Study Type
OBSERVATIONAL
Enrollment
22
Simultaneous bi-atrial electroanatomic mapping during atrial fibrillation and during pacing from 3 different vectors at varying cycle lengths followed by pulmonary vein isolation and AcQMap guided ablation of non-pulmonary vein mechanisms.
John Radcliffe Hospital
Oxford, Oxfordshire, United Kingdom
Spatiotemporal distribution of non-pulmonary vein focal impulses identified during non-contact mapping of atrial fibrillation
The number and location of focal impulses will be collected over 2 recordings
Time frame: Catheter ablation procedure
Spatiotemporal distribution of irregular and rotational activation during 2 recordings of atrial fibrillation
Number of sites of irregular and rotational activation (LA and RA) and their frequency over time during 2 recordings of atrial fibrillation
Time frame: Catheter ablation procedure
Frequency of inter-atrial wavefront propagation during AF
Proportion of wavefronts originating in each atria activating from left to right and right to left and site of inter-atrial conduction
Time frame: Catheter ablation procedure
Outcome of AcQMap guided catheter ablation of atrial fibrillation
Freedom from recurrent atrial fibrillation on 12 lead ECG or \>30seconds on ambulatory monitoring
Time frame: 12 months
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