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

D-PO05-172 - Identifying Critical Isthmuses During Reentrant Atrial Tachycardia Using Supermap® Multi-position Non-contact Charge Density Mapping (ID 1292)


Background: Reentrant atrial tachycardias (AT) can be challenging to map due to low amplitude atrial electrograms in areas of abnormal conduction. Low amplitude regions often contain isthmuses critical to maintenance of the arrhythmia. SuperMap, a multi-position, non-contact (MPNC) mapping method (AcQMap, Acutus Medical), time-aligns data from multiple catheter positions to a stable reference to quickly create high-resolution, full-chamber maps that can be used to identify these critical isthmuses.
Objective: Evaluate SuperMap’s ability to determine the critical isthmus in reentrant AT.
Methods: In a retrospective analysis, SuperMap was used to create propagation maps (n=9) of reentrant AT in 8 patients, from which active area (AA) maps and streamline (SL) plots were made. AA maps indicate the percent of atrial tissue that is active (depolarizing) during the AT cycle length. Valleys in AA maps are often concurrent with isthmus conduction. SL plots show the flow of conduction by tracking atrial depolarization throughout the cardiac cycle. Sites of isthmus conduction were identified within the valley of the AA plot with SL exiting the region with outward conduction. These sites were compared to the ablation site that resulted in SR.
Results: SuperMap data was acquired in 132 ± 45 s. All patients were ablated to SR. The AA maps and SL plots identified the site of rhythm termination in 8/9 cases.
Conclusion: AA maps with SL plots derived from SuperMaps can be used to identify isthmus conduction during reentrant AT.