Abstract 16604: A Novel Endocardial Activation Analysis Software to Identify Rapid Activation Patterns During Atrial Fibrillation
Introduction: The cornerstone of atrial fibrillation (AF) radiofrequency ablation (RFA) is pulmonary vein (PV) isolation. A recently described technique directs RFA to electrical rotors identified by computational analyses of 64-electrode basket catheter (BC) endocardial recordings of AF.
Hypothesis: The purpose of this study was to develop and then to assess the ability of a novel analysis method, CartoFinder™ (CF), incorporated into a 3D mapping system, CARTO (Biosense Webster, CA, USA) to identify rapid activation patterns (RAP).
Methods: 20 patients who were undergoing RFA AF utilizing CARTO mapping and who consented were enrolled. 1 minute BC maps of the right (RA) and left (LA) were obtained after creation of a 3D virtual anatomic shell prior to and after RFA around the PV. In each atria, 2 BC recordings were obtained at the same location, separated by 5 minutes.
Results: Unipolar signals from the BC were recorded by CARTO and analyzed offline. The signal was processed to filter out far-field ventricular activity and the remaining signals were analyzed to create dynamic 3D activation maps and visually identify RAP. CF labels the leading edge of activation with a red color. Of these 20 patients, CF recordings were complete in 14 pts (mean age 59; 12 with persistent AF). There were 2.8 RAP / pt. (mean 1.3 RA; 1.6 LA). No RAP were recorded in 2 pts. The correlation of the BC separated by 5 minutes to identify the same RAP was 12/15 in RA and 15/18 in LA (total: 27/33, 82%).
Conclusions: CF is a newly developed online technique to identify RAP incorporated into a conventional 3D mapping system. RAPs can be identified in the majority of patients undergoing RFA AF with approximately 80% reproducibility.
Author Disclosures: R. Weiss: Research Grant; Modest; Biosense Webster. Speakers Bureau; Modest; Boston Scientific. Honoraria; Modest; Boston Scientific. Z. Zeidan: Employment; Significant; Biosense Webster. J.D. Hummel: Research Grant; Modest; Biosense Webster. Consultant/Advisory Board; Modest; Medtronic. S.J. Kalbfleisch: Research Grant; Modest; Biosense Webster. Consultant/Advisory Board; Modest; St. Jude. R. Augostini: Research Grant; Modest; Biosense Webster. Honoraria; Modest; Respicardia. Consultant/Advisory Board; Modest; Respicardia. M. Houmsse: Research Grant; Modest; Biosense Webster. Honoraria; Modest; Medtronic. E.G. Daoud: Research Grant; Modest; Biosense Webster. Consultant/Advisory Board; Modest; St Jude, Medtronic.
- © 2014 by American Heart Association, Inc.