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Validation of a novel mapping system and utility for mapping complex atrial tachycardias

Honarbakhsh, S; Hunter, RJ; Dhillon, G; Ullah, W; Keating, E; Providencia, R; Chow, A; ... Schilling, RJ; + view all (2018) Validation of a novel mapping system and utility for mapping complex atrial tachycardias. Journal of Cardiovascular Electrophysiology , 29 (3) , Article 13437. 10.1111/jce.13437. Green open access

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Abstract

1 Introduction: This study sought to validate a novel wavefront mapping system utilizing whole‐chamber basket catheters (CARTOFINDER, Biosense Webster). The system was validated in terms of (1) mapping atrial‐paced beats and (2) mapping complex wavefront patterns in atrial tachycardia (AT). 2 Methods and results: Patients undergoing catheter ablation for AT and persistent AF were included. A 64‐pole‐basket catheter was used to acquire unipolar signals that were processed by CARTOFINDER mapping system to generate dynamic wavefront propagation maps. The left atrium was paced from four sites to demonstrate focal activation. ATs were mapped with the mechanism confirmed by conventional mapping, entrainment, and response to ablation. Twenty‐two patients were included in the study (16 with AT and 6 with AF initially who terminated to AT during ablation). In total, 172 maps were created with the mapping system. It correctly identified atrial‐pacing sites in all paced maps. It accurately mapped 9 focal/microreentrant and 18 macroreentrant ATs both in the left and right atrium. A third and fourth observer independently identified the sites of atrial pacing and the AT mechanism from the CARTOFINDER maps, while being blinded to the conventional activation maps. 3 Conclusions: This novel mapping system was effectively validated by mapping focal activation patterns from atrial‐paced beats. The system was also effective in mapping complex wavefront patterns in a range of ATs in patients with scarred atria. The system may therefore be of practical use in the mapping and ablation of AT and could have potential for mapping wavefront activations in AF.

Type: Article
Title: Validation of a novel mapping system and utility for mapping complex atrial tachycardias
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/jce.13437
Publisher version: https://doi.org/10.1111/jce.13437
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: atrialfibrillation, atrialflutter, atrialtachycardia, catheterablation, mappingsystem
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/10057438
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