EP 101 2020: A Virtual Program for Incoming EP Fellows-Ablation of Atrial Tachycardia

Video Transcription

Video Summary

The video discussed the ablation of atrial tachycardias and the different patterns of activation that can be observed. A focal pattern of activation means that activation begins at one site and radiates out in all directions. This type of tachycardia can be seen in people with normal hearts, but also in patients with atrial fibrillation. In contrast, a macro-reentrant pattern of activation is typically seen in heavily scarred or dilated atria. The video emphasized the importance of careful electrode placement and interpretation of electrograms in mapping and successfully ablating atrial tachycardias. It explained the use of bipolar and unipolar electrograms, with the bipolar electrograms being used to eliminate far-field signals and the unipolar electrograms providing directional information. The video also discussed the importance of high-resolution recording and the use of filters to minimize baseline drift. It provided examples of mapping and ablation procedures for atrial tachycardias in the right atrium and left atrial appendage, highlighting the importance of accurate electrode placement to target the site of earliest activation. The video concluded by discussing the limitations of catheter movement and the impact on electrogram recordings.

Asset Subtitle

Warren “Sonny” Jackman, MD

Keywords

ablation

atrial tachycardias

activation patterns

focal activation

macro-reentrant activation

electrode placement

electrograms

mapping and ablation procedures