Catheter Ablation -> SVT/AVNRT/WPW/AT: -> Mapping & Imaging D-PO05 - Poster Session V (ID 39) Poster

D-PO05-162 - Validation Of Supermap® Multi-position Noncontact Mapping In Complex Atrial Tachycardias (ID 1287)

Abstract

Background: Mapping complex atrial tachycardias (AT) can be challenging due to low voltage atrial electrograms (EGM) in areas of abnormal conduction. Multi-position noncontact (MPNC) mapping uses a stable reference to time-align non-contact (NC) data acquired with a 48-electrode catheter (AcQMap) during AT, using a charge-density inverse solution to reconstruct EGMs across the chamber.
Objective: To evaluate reconstructed NC vs. measured contact EGMs during AT.
Methods: MPNC maps (N=15) were acquired in 10 patients. During MPNC data acquisition, contacting electrodes (N=7740) were considered gold standard contact EGMs and used for comparison. Cross-correlation and time lag were calculated between measured contact EGMs and the nearest reconstructed NC EGMs from the MPNC map. The peak to peak (P2P) unipolar voltage was computed for both contact and NC EGMs. A paired t-test was used to assess similarity of P2P voltages.
Results: MPNC maps were acquired over 131 ± 30 s. The cross-correlation and time lag between resulting reconstructed NC EGMs and measured contact EGMs was 0.91 [0.81,0.97] and 1.6 [0.00,4.48] ms (median [25%,75%]) respectively. The median P2P voltage for contact (3.23±1.86 mV) and NC (3.23±2.01 mV) were not significantly different (p=0.95) for each map. Figure 1 shows an example of contact and NC EGM trace comparisons.
Conclusion: MPNCM is a novel mapping method that quickly acquires data to map complex AT. NC EGMs accurately reconstruct morphology, timing and amplitude of unipolar contact EGMs, including low voltage areas that are often critical sites for maintaining AT.
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