Patterns and Characteristics of SKYLINE-Lumipoint Feature in the Catheter Ablation of Atypical Atrial Flutter: Insight from a Novel Lumipoint Module of Rhythmia Mapping System

Cheng Hung Li, Li Wei Lo*, Ankit Jain, Yu Cheng Hsieh, Yenn Jiang Lin, Shih Lin Chang, Fa Po Chung, Yu Feng Hu, Tze Fan Chao, Jo Nan Liao, Ting Yung Chang, Chin Yu Lin, Isaiah Carlos Lugtu, An Nu Khanh Ton, Shin Huei Liu, Wen Han Cheng, Chih Min Liu, Cheng I. Wu, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Atypical atrial flutter (aAFL) is not uncommon, especially after a prior cardiac surgery or extensive ablation in atrial fibrillation (AF). Aims: To revisit aAFL, we used a novel Lumipoint algorithm in the Rhythmia mapping system to evaluate tachycardia circuit by the patterns of global activation histogram (GAH, SKYLINE) in assisting aAFL ablation. Methods: Fifteen patients presenting with 20 different incessant aAFL, including two naïve, six with a prior AF ablation, and seven with prior cardiac surgery were studied. Results: Reentry aAFL in SKYLINE typically was a multi-deflected peak with 1.5 GAH-valleys. Valleys were sharp and narrow-based. Most reentry aAFL (18/20, 90%) lacked a plateau and displayed a steep GAH-valley with 2 GAH-valleys per tachycardia. Each GAH-valley highlighted 1.9 areas in the map. Successful sites of ablation all matched one of the highlighted areas based on GAH-valleys < 0.4. These sites corresponded with the areas highlighted by GAH-score < 0.4 in reentry aAFL, and by GAH-score < 0.2 in localized-reentry aAFL. Conclusions: The present study showed benefits of the Lumipoint™ module applied to the RhythmiaTM mapping system. The results were the efficient detection of the slow conduction, better identification of ablation sites, and fast termination of the aAFL with favorable outcomes.

Original languageEnglish
Article number1102
JournalJournal of Personalized Medicine
Volume12
Issue number7
DOIs
StatePublished - Jul 2022

Keywords

  • atypical atrial flutter
  • catheter ablation
  • global activation histogram
  • high-density mapping system
  • Lumipoint algorithm

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