real-time-cardiac-mapping-with-noninvasive-imageless

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Rapid, safe, and effective cardiac mapping is critical for the management of complex arrhythmias, yet current methods face significant limitations. The ...

Universitat de Barcelona

An increased burden of premature atrial contractions (PACs) has long been considered a benign phenomenon. However, strong evidence of their involvement in the occurrence of atrial fibrillation (AF), ischemic stroke, and excess mortality suggests the need for management. The central question to be resolved is whether increased ectopic atrial rhythm is only a predictor of AF or whether it is a marker of atrial cardiomyopathy and therefore of ischemic stroke. After reviewing the pathophysiology of PACs and its impact on patient prognosis, this mini-review proposes to 1) detail the physiological and clinical elements linking PACs and AF, 2) present the evidence in favor of supraventricular ectopic activity as a marker of cardiomyopathy, and 3) outline the current limitations of this concept and the potential future clinical implications.

Premature atrial contractions: A predictor of atrial fibrillation and a relevant marker of atrial cardiomyopathy.

Addressing the challenging yet vital task of managing atrial fibrillation in older adults to prevent heart failure.

Recurrence of arrhythmia after catheter ablation of atrial fibrillation (AF) in the form of atypical atrial flutter (AFL) is common among a significant number of patients and often requires redo ablation with limited success rates. Identifying patients at high risk of AFL after AF ablation could aid in patient selection and personalized ablation approach. The study aims to assess the relationship between pre-existing atrial cardiomyopathy and the occurrence of AFL following AF ablation.

Magnetic resonance detection of advanced atrial cardiomyopathy increases the risk for atypical atrial flutter occurrence following atrial fibrillation ablation.

Preventing ischaemic stroke in patients with isolated sinus node disease: the value of evaluating atrial cardiomyopathy.

Failure of Left Bundle Branch Pacing Owing to Iterative Septal Perforation: A Word of Caution for Thin Septum and Highly Dilated Cardiomyopathy.

Implications of atrial cardiomyopathy in the incidence of cardioembolic events in patients with cryptogenic stroke.

Atrial arrhythmogenic substrate is a key determinant of atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI), and reduced conduction velocities have been linked to adverse outcome. However, a noninvasive method to assess such electrophysiologic substrate is not available to date.

Regional conduction velocities determined by noninvasive mapping are associated with arrhythmia-free survival after atrial fibrillation ablation.

Voltage mapping could identify the conducting channels potentially responsible for ventricular tachycardia (VT). Standard thresholds (0.5-1.5 mV) were established using bipolar catheters. No thresholds have been analyzed with high-density mapping catheters. In addition, channels identified by cardiac magnetic resonance (CMR) has been proven to be related with VT.

Personalized voltage maps guided by cardiac magnetic resonance in the era of high-density mapping.

A partial delineation of targets for ablation of ventricular tachycardia (VT) during a stable rhythm is likely responsible for a suboptimal success rate. The abnormal low-voltage near-field functional components may be hidden within the high-amplitude far-field signal.

Substrate Mapping for Ventricular Tachycardia Ablation Through High-Density Whole-Chamber Double Extra Stimuli: The S3 Protocol.

Left bundle branch pacing (LBBP) is considered an alternative to cardiac resynchronization therapy (CRT). However, LBBP is not suitable for all patients with heart failure.

Predictors of failed left bundle branch pacing implant in heart failure with reduced ejection fraction: Importance of left ventricular diameter and QRS morphology.

Article	Year
Premature atrial contractions: A predictor of atrial fibrillation and a relevant marker of atrial cardiomyopathy. Frontiers in physiology\| PubMed ID: 36353376	2022
Addressing the challenging yet vital task of managing atrial fibrillation in older adults to prevent heart failure. Revista espanola de cardiologia (English ed.)\| PubMed ID: 37543191	2024
Magnetic resonance detection of advanced atrial cardiomyopathy increases the risk for atypical atrial flutter occurrence following atrial fibrillation ablation. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology\| PubMed ID: 37751383	2023
Preventing ischaemic stroke in patients with isolated sinus node disease: the value of evaluating atrial cardiomyopathy. European journal of preventive cardiology\| PubMed ID: 38085027	2024
Failure of Left Bundle Branch Pacing Owing to Iterative Septal Perforation: A Word of Caution for Thin Septum and Highly Dilated Cardiomyopathy. The Canadian journal of cardiology\| PubMed ID: 38163478	2024
Implications of atrial cardiomyopathy in the incidence of cardioembolic events in patients with cryptogenic stroke. Revista espanola de cardiologia (English ed.)\| PubMed ID: 38555068	2024
Regional conduction velocities determined by noninvasive mapping are associated with arrhythmia-free survival after atrial fibrillation ablation. Heart rhythm\| PubMed ID: 38636930	2024
Personalized voltage maps guided by cardiac magnetic resonance in the era of high-density mapping. Heart rhythm\| PubMed ID: 38670249	2024
Substrate Mapping for Ventricular Tachycardia Ablation Through High-Density Whole-Chamber Double Extra Stimuli: The S3 Protocol. JACC. Clinical electrophysiology\| PubMed ID: 38819348	2024
Predictors of failed left bundle branch pacing implant in heart failure with reduced ejection fraction: Importance of left ventricular diameter and QRS morphology. Heart rhythm\| PubMed ID: 38906515	2024
Postablation Arrhythmogenic Channels Predict Atrial Fibrillation Recurrence: Iatrogenic Substrate Revisited. JACC. Clinical electrophysiology\| PubMed ID: 39846929	2025

Jean-Baptiste Guichard

Biography

JoVE Journal Publications

Other Publications