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

D-PO05-164 - "Supermap" - Utility Of High Density Non-contact System For Synchronous Mapping Of Atrial Pacing (ID 575)

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Background: “Supermap” is a new tool for the mapping of organized atrial arrhythmias using the AcQMap non-contact mapping system.
Objective: To undertake mapping during atrial pacing at varying cycle lengths from a static site to test the utility of the system.
Methods: Maps were created following cardioversion in 3 patients undergoing catheter ablation for AF. Pacing was performed from the proximal coronary sinus at output twice threshold using a repeating protocol of a 3 beat drive train followed by a single extra-stimulus at 10ms longer than the effective refractory period. Outcomes were the time taken for map creation and display, the accuracy of beat detection/grouping at the 2 pacing cycle lengths and the number of atrial points included for each beat detection.
Results: Recordings were taken for 5minutes(m) 1second(s), 4m33s and 2m58s respectively. Automated post-processing took 1m8s, 39s and 25s. Total times from the start of mapping to viewing a map were 6m9s, 5m12s and 3m22s. In all patients, the 2 cycle lengths were accurately discriminated. Automated beat detection identified 2 groups for patient one (occupying 73% and 25% of signals), 4 groups in patient 2 (23%, 20%, 18% and 16%) and 4 groups in patient 3 (30%, 24%, 11% and 8%). The additional beat groups were a result of ectopy and sinus beats following occasional non-capture. Following manual adjustment of the beat detection window grouping was improved to 56%, 20% and 3% in patient 2 and 60%, 10%, 10% and 7% in patient 3. See table for full results.
Conclusion: “Supermap” is quick and accurately able to discriminate rhythms based on cycle length alone. Minor manual adjustment of the beat detection window may be required for optimization.