title: Simple and accurate catheter mapping technique to predict atrial fibrillation foci in the pulmonary veins or posterior right atrium.
abstract: OBJECTIVE
  The purpose of this study was to investigate the efficacy of a novel catheter mapping technique for predicting atrial fibrillation (AF) foci.
  
  
  BACKGROUND
  Most AF originates from pulmonary veins (PVs), but some originate from the right atrium.
  
  
  METHODS
  We developed an algorithm by correlating the cardiac recordings obtained from multielectrode catheters placed in the posterior right atrium (RA) and esophagus during pacing from the PVs and superior vena cava (SVC) or crista terminalis (CT) in 10 AF patients. We tested the algorithm's accuracy prospectively in 46 AF patients.
  
  
  RESULTS
  During pacing from the left PVs, the esophageal potentials preceded all other potentials. During pacing from both the right PVs and SVC-CT, the first component (FP) of the double potential (DP) recorded in the posterior RA preceded all other potentials. The amplitude of the FP was higher than that of the second DP component during pacing from the SVC-CT, whereas the reverse occurred from the right PVs. The activation sequence of the FPs and esophageal potentials was from superior to inferior during pacing from the superior PVs, whereas the reverse occurred from the inferior PVs. The accuracy of predicting 34 foci in the right PVs, 28 foci in left PVs, and 6 foci in SVC-CT was 100% for all, respectively. The accuracy of discriminating foci in the superior PVs from those in the inferior PVs was 97% in the right PVs and 96% in the left PVs.
  
  
  CONCLUSIONS
  The technique using mapping catheters placed in the posterior RA and esophagus is feasible and effective for mapping and ablating AF.
authors.affiliation: Division of Cardiology, Aichi Prefectural Owari Hospital, Cardiovascular Center, Ichinomiya, Japan. takumi-y@fb4.so-net.ne.jp
authors.forename: Takumi
authors.initials: T
authors.lastname: Yamada
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Murakami
authors.forename: Masahiro
authors.initials: M
authors.lastname: Muto
authors.forename: Taro
authors.initials: T
authors.lastname: Okada
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Okamoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimizu
authors.forename: Junji
authors.initials: J
authors.lastname: Toyama
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Naoya
authors.initials: N
authors.lastname: Tsuboi
authors.forename: Teruo
authors.initials: T
authors.lastname: Ito
authors.forename: Takahisa
authors.initials: T
authors.lastname: Kondo
authors.forename: Yasuya
authors.initials: Y
authors.lastname: Inden
authors.forename: Makoto
authors.initials: M
authors.lastname: Hirai
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000465:Algorithms; D001281:Atrial Fibrillation / Q000503:physiopathology*; D018780:Body Surface Potential Mapping / Q000379:methods*; D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000503:physiopathology*