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Updated: Jul 24, 2025
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Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
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Electrogram morphology recurrence guided catheter ablation for repeat ablation of persistent atrial fibrillation
Raul D Mitrani1, Ghaith Zaatari1, Jorge Bohorquez2
1Division of Cardiology, University of Miami, 1120 NW 14th St.Clinical Research Building, 1124, 33161, Miami, FL, USA.
Summary
Electrogram Morphology Recurrence (EMR) is a new method to guide catheter ablation (CA) for persistent atrial fibrillation (PeAF) after previous procedures. This technique shows promise in reducing recurrent PeAF, improving patient outcomes.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Technology
Background:
- Standardized mapping techniques for persistent atrial fibrillation (PeAF) after catheter ablation (CA) failure are lacking.
- Novel approaches are needed to guide repeat ablation procedures effectively.
Purpose of the Study:
- To assess the feasibility of using Electrogram Morphology Recurrence (EMR) to guide CA in patients with PeAF.
- To evaluate the efficacy of EMR-guided ablation in reducing AF recurrence.
Main Methods:
- Ten patients with recurrent PeAF post-CA underwent detailed atrial mapping using PentaRay and CARTO systems.
- Custom software calculated electrogram recurrence and cycle length (CLR) to identify ablation targets.
- Ablation strategy was informed by sites with shortest CLR and high recurrence rates (≥80%).
Main Results:
- EMR identified target sites in 6 out of 10 patients.
- Patients undergoing EMR-guided CA had significantly lower rates of recurrent PeAF (1/6) compared to those not guided by this method (4/4) (p=0.048).
- Pulmonary vein reconnection was observed in nine patients.
Conclusions:
- Electrogram Morphology Recurrence (EMR) is a feasible and novel technique for guiding CA in persistent atrial fibrillation.
- EMR-guided ablation demonstrates potential for improved clinical outcomes in select patient populations.
- Further research is warranted to refine EMR for targeted ablation strategies.
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