@inproceedings{01JEBQQE90ANMGCAB03KTEMR13,
  abstract     = {{Introduction: Knowing the anatomical origin of atrial arrhythmias is essential before planning ablation. In humans and dogs, multiple catheter mapping allows to characterize arrhythmias but requires fluoroscopy, a poorly applicable technique in horses. The aim was to perform ultrasound-guided multiple catheter mapping via the right heart during left atrial pacing in order to identify specific activation patterns characteristic for the origin of ectopy.
Methods: In seven anesthetized horses, under ultrasound guidance and confirmation by 3D mapping, four decapolar catheters were positioned at the crista terminalis, tuberculum intervenosum, caudal vena cava and coronary sinus (CS) for electrogram recording. After performing a transseptal puncture, a fifth catheter was used to pace (45/min) in the left atrium at left atrial appendage, septum, ostium I, II, III and IV. Atrial activation timings were recorded for each pacing site, relative to the pacing stimulus (0 ms).
Results: Pacing the left atrial appendage sequentially activated CS (38[IQR 54]ms), tuberculum (100[32]ms), crista (115[43]ms) and caudal vena cava (127[53]ms). Pacing the septum activated the caudal vena cava (67[24]ms), tuberculum (71[22]ms), CS (87[24]ms) and crista (102[36]ms). Activation patterns from ostium I and II were: CS (60[20]ms; 76[24]ms, respectively), caudal vena cava (103[17]ms; 84[40]ms), tuberculum (124[34]ms; 119[92]ms) and crista (145[14]; 131[58]ms). Pacing ostium III activated tuberculum (66[18]ms), caudal vena cava (70[33]ms], crista (93[21]ms) and CS (123[13]ms). Pacing ostium IV activated CS (81[36]ms), tuberculum (107[44]ms), caudal vena cava (119[36]ms) and crista (139[16]ms). 
Conclusion: Pacing-induced ectopic depolarizations from the left atrium result in characteristic multiple catheter activation patterns. 
Clinical relevance: Ablation of pulmonary veins has been performed experimentally but is very challenging, requiring a long anesthesia. Knowing the anatomical origin of atrial premature depolarizations is helpful to target specific pulmonary veins for ablation in order to reduce atrial fibrillation recurrence and might reveal which pulmonary veins are most often arrhythmogenic.}},
  author       = {{Buschmann, Eva and Van Steenkiste, Glenn and Vernemmen, Ingrid and Demeyere, Marie and Schauvliege, Stijn and Decloedt, Annelies and van Loon, Gunther}},
  booktitle    = {{17th Annual ECEIM Congress 2024, Abstracts}},
  keywords     = {{equine cardiology,electrophysiology,arrythmias,ablation}},
  language     = {{eng}},
  location     = {{Copenhagen, Denmark}},
  pages        = {{1}},
  title        = {{Identifying the origin of left atrial ectopy, including pulmonary veins, via multiple catheter recording in the right heart}},
  url          = {{https://www.eceim-congress.com/}},
  year         = {{2024}},
}