2024 Volume 44 Issue 3 Pages 159-166
Entrainment is a useful method for locating reentrant atrial tachycardia（AT）circuits, but alterations or termination of the AT can derail this process. AT resetting by the delivery of a scanned atrial extrastimulus at a site of activation downstream from the neighboring electrodes on a multielectrode catheter when the upstream tissue is refractory may be a useful diagnostic maneuver to avoid AT alterations and termination. In this study, we evaluated the diagnostic performance and the frequency of AT alterations and termination in entrainment pacing and the scanned atrial extrastimulus for 48 atrial tachycardias. The positive predictive value for both diagnostic maneuvers was 100％, and the negative predictive value was equivalent for the entrainment pacing and the scanned atrial extrastimulus（96％ vs. 100％, P＝0.25）. The frequency of AT alterations and termination due to diagnostic maneuver was lower with scanned atrial extrastimulus than with entrainment pacing（1％ vs. 10％, P＝0.003）. Scanned atrial extrastimulus using a multielectrode mapping catheter may enable the diagnosis of AT circuits while avoiding AT alterations and termination.
