Imperial College London
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Dr Daniel Keene MBChB, MSc (Distinction), MRCP, PhD

Faculty of Medicine, National Heart & Lung Institute

Clinical Senior Lecturer in Cardiology (Clinical)
 
 
 
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d.keene

 
 
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Location

 

Block B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Coyle:2023:10.1007/s10840-023-01517-9,
author = {Coyle, C and Koutsoftidis, S and Kim, M-Y and Porter, B and Keene, D and Luther, V and Handa, B and Kay, J and Lim, E and Malcolme-Lawes, L and Koa-Wing, M and Lim, PB and Whinnett, ZI and Ng, FS and Qureshi, N and Peters, NS and Linton, NWF and Drakakis, E and Kanagaratnam, P},
doi = {10.1007/s10840-023-01517-9},
journal = {Journal of Interventional Cardiac Electrophysiology: an international journal of arrhythmias and pacing},
title = {Feasibility of mapping and ablating ectopy-triggering ganglionated plexus reproducibly in persistent atrial fibrillation},
url = {http://dx.doi.org/10.1007/s10840-023-01517-9},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundAblation of autonomic ectopy-triggering ganglionated plexuses (ET-GP) has been used to treat paroxysmal atrial fibrillation (AF). It is not known if ET-GP localisation is reproducible between different stimulators or whether ET-GP can be mapped and ablated in persistent AF. We tested the reproducibility of the left atrial ET-GP location using different high-frequency high-output stimulators in AF. In addition, we tested the feasibility of identifying ET-GP locations in persistent atrial fibrillation.MethodsNine patients undergoing clinically-indicated paroxysmal AF ablation received pacing-synchronised high-frequency stimulation (HFS), delivered in SR during the left atrial refractory period, to compare ET-GP localisation between a custom-built current-controlled stimulator (Tau20) and a voltage-controlled stimulator (Grass S88, SIU5). Two patients with persistent AF underwent cardioversion, left atrial ET-GP mapping with the Tau20 and ablation (Precision™, Tacticath™ [n = 1] or Carto™, SmartTouch™ [n = 1]). Pulmonary vein isolation (PVI) was not performed. Efficacy of ablation at ET-GP sites alone without PVI was assessed at 1 year.ResultsThe mean output to identify ET-GP was 34 mA (n = 5). Reproducibility of response to synchronised HFS was 100% (Tau20 vs Grass S88; [n = 16] [kappa = 1, SE = 0.00, 95% CI 1 to 1)][Tau20 v Tau20; [n = 13] [kappa = 1, SE = 0, 95% CI 1 to 1]). Two patients with persistent AF had 10 and 7 ET-GP sites identified requiring 6 and 3 min of radiofrequency ablation respectively to abolish ET-GP response. Both patients were free from AF for > 365 days without anti-arrhythmics.ConclusionsET-GP sites are identified at the same location by different stimulators. ET-GP ablation alone was able to prevent AF recurrence in persistent AF, and further studies would be warranted
AU  - Coyle,C
AU  - Koutsoftidis,S
AU  - Kim,M-Y
AU  - Porter,B
AU  - Keene,D
AU  - Luther,V
AU  - Handa,B
AU  - Kay,J
AU  - Lim,E
AU  - Malcolme-Lawes,L
AU  - Koa-Wing,M
AU  - Lim,PB
AU  - Whinnett,ZI
AU  - Ng,FS
AU  - Qureshi,N
AU  - Peters,NS
AU  - Linton,NWF
AU  - Drakakis,E
AU  - Kanagaratnam,P
DO  - 10.1007/s10840-023-01517-9
PY  - 2023///
SN  - 1383-875X
TI  - Feasibility of mapping and ablating ectopy-triggering ganglionated plexus reproducibly in persistent atrial fibrillation
T2  - Journal of Interventional Cardiac Electrophysiology: an international journal of arrhythmias and pacing
UR  - http://dx.doi.org/10.1007/s10840-023-01517-9
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000943123100001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
UR  - http://hdl.handle.net/10044/1/106408
ER  -
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