Pediatric/Adult Congenital Heart Disease -> Adult Congenital Heart Disease D-PO02 - Poster Session II (ID 47) Poster

D-PO02-076 - New Wavefront Activation Algorithm Vs Standard Bipolar Map Using A High-definition Grid-catheter For Scar And Arrhythmic Isthmus Identification In Patients With Tga (ID 1003)


Background: Precise identification of atrial scar in patients with D-TGA repaired with Senning/Mustard surgeries can be critical to guide the ablation. High-density mapping using a grid-catheter with a new wave front activation algorithm has shown to better scar identification in other substrates.
Objective: To describe the feasibility of using a specific mapping catheter to identify possible arrhythmic isthmus in this set of patients and evaluate the differences in the scar characterization between a new wavefront activation algorithm compared with the standard bipolar map.
Methods: Prospective observational study in patients with history of AT and atrial switch surgery, that underwent EP study and EA mapping with a new HD-Grid catheter, in a third level hospital since April 2018 until May 2019. The same points were evaluated both with new HDWave algorithm and conventional bipolar.
Results: A total of 8 EPs were performed in 7 patients (3 (57%) Female, median age 35±6 y.o) Six AT were induced, in all of them an arrhythmogenic isthmus was identified. Likewise, at least one non-arrhytmogenic isthmus was documented in all patients. Figure 1A shows the localization and percentage of scar identified in both atria. Figure 1B summarizes the differences in scar and EGMs characterization between the two maps. Using the new-wavefront activation algorithm core zone area was smaller while EGMs voltage was higher.
Conclusion: EA mapping with a new Grid Cather is feasible and allows the identification and precise characterization of atrial scars and arrhythmogenic isthmus in patients with TGA.