{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T08:36:40Z","timestamp":1789202200613,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,11,10]],"date-time":"2019-11-10T00:00:00Z","timestamp":1573344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the role of ultrahigh\u2010density mapping for conduction isthmus (CI) characterization in adult congenital heart disease (ACHD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Catheter ablation remains suboptimal for ACHD with atypical intra\u2010atrial reentrant tachycardias (IART) that can be challenging to define using existing mapping technology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An ultrahigh\u2010density mapping system was selectively employed over a 1\u2010year period for procedures involving noncavotricuspid isthmus\u2010dependent\u2010IART. A global activation histogram (GAH) was assessed for the ability to predict ablation targets. Procedural characteristics were compared to a group of matched controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty patients (mean age 43\u2009\u00b1\u200915, 70% male) underwent 20 procedures targeting 34 tachycardias during the study period. Diagnoses included single ventricle (8), tetralogy of Fallot (2), left heart obstruction (3), Ebstein's anomaly (2) atrial septal defect (2), Mustard operation (2), and Rasteilli operation (1). Prior catheter ablation\/Maze operation had been performed in 12 (60%). The median time per map was 21\u2009minutes (interquartile range [IQR], 16\u201032), representing 14\u2009834 points per map (IQR 9499\u201043\u2009191; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001 vs controls). Review of GAH maps showed lower trough values were associated with more favorable IART CI characteristics (<jats:italic>P<\/jats:italic>\u2009\u2264\u2009=.001 for all). Acute success was achieved in 19\/20 (95%) procedures, with tachycardia termination during the first lesion in eight cases (<jats:italic>P<\/jats:italic>\u2009=\u2009.02 vs controls). There was one recurrence during 0.6 years follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ultrahigh\u2010density mapping supplemented with the GAH tool was effective for CI identification in a cohort of complex ACHD patients. Catheter ablation was more efficient compared to controls, suggesting precise CI characterization using this technology.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14251","type":"journal-article","created":{"date-parts":[[2019,10,24]],"date-time":"2019-10-24T04:52:36Z","timestamp":1571892756000},"page":"2797-2805","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Ultrahigh\u2010density mapping supplemented with global chamber activation identifies noncavotricuspid\u2010dependent intra\u2010atrial re\u2010entry conduction isthmuses in adult congenital heart disease"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3089-9005","authenticated-orcid":false,"given":"Jeremy P.","family":"Moore","sequence":"first","affiliation":[{"name":"UCLA Medical Center Ahmanson\/UCLA Adult Congenital Heart Disease Center Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Buch","sequence":"additional","affiliation":[{"name":"UCLA Cardiac Arrhythmia Center David Geffen School of Medicine at UCLA Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto G.","family":"Gallotti","sequence":"additional","affiliation":[{"name":"UCLA Medical Center Ahmanson\/UCLA Adult Congenital Heart Disease Center Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin M.","family":"Shannon","sequence":"additional","affiliation":[{"name":"UCLA Medical Center Ahmanson\/UCLA Adult Congenital Heart Disease Center Los Angeles 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