Dr. Ahmed Eldamaty is a lecturer of cardiovascular medicine, Cairo University. He is a consultant in the field of clinical cardiac electrophysiology and pacing. He is among few physicians experienced in that field in Egypt and the Middle East.
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BACKGROUND: Surface ECG is a useful tool to guide mapping of focal atrial tachycardia (AT). We have previously
proposed an algorithm based on paced P wave morphology
templates by pacing from different anatomical sites in both
atria.
OBJECTIVE: Validation of this algorithm in a retrospective series of AT patients who underwent catheter ablation.
METHODS: We prospectively enrolled consecutive patients
who underwent electrophysiology study, had no heart disease
and no atrial enlargement. Atrial pacing, at twice diastolic
threshold, was carried out at different anatomical sites in
both atria. Paced P wave morphology and duration were
assessed. An algorithm was generated from the constructed
templates of each pacing site. The algorithm was applied on a
retrospective series of successfully ablated AT patients between 2006 and 2016. Overall and site-specific accuracy
were determined.
RESULTS: Derivation cohort included 65 patients (25 men,
age 3713 years). Atrial pacing was performed in 1025 sites
in 61 patients (95%) in the right atrium and in 15 patients
(23%) in the left atrium. The validation cohort included 71
patients (28 men, age 5219 years). AT were right atrial in
66.2%. The algorithm successfully predicted AT origin in
91.5% of patients (100% in LA and 87.2% in RA). It was off
by 1 adjacent segment in the remaining 8.5%. Site-specific
accuracies are shown in Table1.
CONCLUSION: A simple ECG algorithm based on paced
P-wave morphology templates was highly accurate in localizing sites of origin of focal atrial tachycardia particularly those
of LA origin.
Sapp, J. L., M. D. Christopher Gray, M. D. Ratika Parkash, M. D. Magdy Basta, M. D. Josee Michaud, A. El-Damaty, M. D. Ali Khadem, M. D. Jeremy Wood, and M. D. Martin Gardner, "Catheter Ablation of Idiopathic Ventricular Fibrillation: A Role For The Moderator Band", CANADIAN JOURNAL OF CARDIOLOGY, vol. 26: PULSUS GROUP INC 2902 S SHERIDAN WAY, OAKVILLE, ONTARIO L6J 7L6, CANADA, pp. 104D–104D, 2010.
Abstract