Repetitive atrial activation during ongoing atrial fibrillation-comparison using different mapping algorithms: preliminary findings.
Philipp Halbfass, Patrick Müller, Karin Nentwich, Kai Sonne, Karsten Hamm, Sebastian Barth, Franziska Fochler, Andreas Mügge, Thomas Deneke
Author Information
Philipp Halbfass: Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany. halbfass@gmx.net. ORCID
Patrick Müller: Cardiac Arrhythmia Service, Division of Cardiology, Pulmonology and Vascular Medicine, University Düsseldorf, Medical Faculty, Düsseldorf, Germany.
Karin Nentwich: Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany.
Kai Sonne: Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany.
Karsten Hamm: Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany.
Sebastian Barth: Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany.
Franziska Fochler: Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany.
Andreas Mügge: Ruhr-University Bochum, Bochum, Germany.
Thomas Deneke: Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany.
PURPOSE: Targeting repetitive sources identified during atrial fibrillation (focal impulse and rotor modulation, FIRM) has been used as an ablation strategy using specific mapping tools. Aim of this study was to evaluate FIRM mapped rotors with a new multipolar mapping algorithm. METHODS: patients with persistent atrial fibrillation undergoing FIRM ablation were included. Mapping of left atrial rotors was performed with a 64-pole basket catheter in conjunction with a specialized phase mapping algorithm. Subsequently, raw signals were analyzed by a novel mapping system (CF™). Comparison of FIRM identified sources with areas of repetitive activation analyzed by CF™ was performed. RESULTS: Nine patients were included (5 redo procedures; male n = 6; 66.5 ± 8.6 years) and 28 left atrial rotors were compared with the findings of the novel mapping system. CF™ identified repetitive activation patterns in 6 mapping sequences at remote sites (2 rotational patterns, 4 linear activation patterns). CONCLUSIONS: In this comparative preliminary study, two different mapping technologies to detect repetitive atrial activation during ongoing AF were used. Whereas rotational activation was documented using FIRM mapping no corresponding repetitive activation patterns near sites of FIRM-mapped rotor cores were identified using the novel mapping technology even though using the same electrogram characteristics and mapping basket position.
