Non-invasive characterisation of macroreentrant atrial tachycardia types from a vectorcardiographic approach with the slow conduction region as a cornerstone

Macroreentrant atrial tachyarrhythmias (MRATs) can be caused by different reentrant circuits. The treatment for each MRAT type may require ablation at sites, either the right or left atria. Unfortunately, circuit that drives arrhythmia cannot ascertained previous to electrophysiological intervention. A noninvasive approach based on comparison of vectorcardiogram (VCG) loops is proposed. An archetype group was created, which served as a reference measure similarity between loops. Methods were tested in variety simulations and real data obtained from most common (peritricuspid) (perimitral) macroreentrant circuits, divided into clockwise counterclockwise subgroups. Adenosine administered patients induce transient AV block, allowing recording signal without interference ventricular signals. From vectorcardiogram, we measured intrapatient loop consistence, pathway archetypes, characterisation slow velocity regions complexity. Results show considerably higher with its corresponding archetype, both data. We found capacity reflect region, consistent mechanisms MRAT, role it plays circuit. intra-patient consistence over 0.85 all clinical cases while archetypes ± 0.03, 0.95 0.87 0.04 0.91 0.02 types (and p<0.02 3 4 groups), complexity also allowed discriminate among (with p<0.05). conclude presented methodology allows us differentiate forms MRATs predict existence location conduction zone. This useful planning procedures advance.