Moisés Rodríguez-Mañero et al. JACEP 2016;j.jacep

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Date of download: 9/19/2016 Copyright © The American College of Cardiology. All rights reserved. From: Noncontact three-dimensional mapping and ablation.

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Presentation transcript:

Moisés Rodríguez-Mañero et al. JACEP 2016;j.jacep.2016.09.014 Mapping and Ablation of IST, and Phrenic Nerve Protection (A to D) Sequential activation maps during inappropriate sinus tachycardia (IST). Black dots mark sites of phrenic nerve capture during high-output pacing. (A) Earliest activation site (red area) is usually mapped in the superior vena cava (SVC)–right atrial (RA) junction. (C to E) After ablation at that site, the earliest activation site shifts downward, requiring consecutive ablations at progressively lower sites. Epicardial balloon for phrenic nerve protection. (E) Balloon positioning via a posterior-inferior pericardial puncture. (F) Balloon positioning via an anterior puncture. (G) Activation maps after balloon positioning, showing indentation of the RA geometry (arrow) and no phrenic nerve capture (no black dots) after balloon inflation. Moisés Rodríguez-Mañero et al. JACEP 2016;j.jacep.2016.09.014 American College of Cardiology Foundation