Catheter Ablation -> Ventricular Arrhythmias -> Mapping & Imaging D-PO06 - Poster Session VI (ID 26) Poster

D-PO06-109 - Comparison Of Intracardiac Non-Contact Calculated Ventricular Electrograms To Measured Contact Electrograms During Mapping: Validating Supermap Technology (ID 1367)


Background: Complex ventricular tachycardias can be challenging to map due to time required to generate complete maps and the presence of low amplitude electrograms (EGMs). SuperMap (Acutus Medical) is a novel mapping method that temporally aligns multiple non-contact unipolar EGMs detected from a roving multielectrode catheter (AcQMap, 0.70 mm2 electrode areas) then applies a charge density (CD) inverse solution to calculate and display global activation and amplitude maps.
Objective: To compare EGMs derived from roving electrodes (not in contact with LV tissue) to those recorded during electrode contact with the LV wall.
Methods: Anterior wall infarcts were induced via intracoronary ethanol infusions in two sheep. After 8 weeks, ultrasound-based anatomical and SuperMap CD maps of the LV were created using AcQMap multielectrode catheters during sinus rhythm and pacing from septal, lateral, and apical locations. At locations where contact EGMs were recorded, the closest corresponding SuperMap-calculated EGM was used for comparison.
Results: After creating ultrasound-based LV geometries, CD acquisition times were 2.9 ± 0.8 minutes per map. In total, 2285 unipolar voltage EGMs were registered during electrode contact with LV tissue. EGM morphology correlation between non-contact and contact EGMs was 0.93 ± 0.11 with a mean temporal delay of 3.6 ± 6.3 msec in EGM onset (Figure). The degree of correlation did not differ based on direction of activation wavefront.
Conclusion: Non-contact SuperMap-derived ventricular EGMs strongly correlate with conventional contact-based EGMs with respect to morphology and timing.