Abstract 17111: Novel Global Ultrasound Imaging and Continuous Dipole Density Mapping: Initial Findings in AF Patients
Introduction: Electro-anatomic mapping is standard practice in AF ablation procedures. Virtual anatomies are created to locate structures and navigate catheters and voltage (V) is used to map arrhythmias.
Methods: A novel non-contact imaging and Dipole Density (DD) mapping system (AcQMap), consisting of a basket catheter (48 Ultrasound (U/S) transducers, 48 electrodes) and console, simultaneously acquires 100,000+ U/S points/min to reconstruct the chamber anatomy and 150,000 intracardiac unipolar V samples/second to map cardiac activity. The 3D surface is algorithmically reconstructed from the U/S point-set with mesh-density comparable to segmented CT (sCT). Inverse and Forward algorithms are applied on intracardiac V to derive and display activation as DD and unipolar V maps, respectively, upon the U/S-constructed 3D anatomy (Figure). Patients listed for AF ablation were consented for U/S and DD mapping. U/S LA anatomy was created from full and sub-sampled point-sets and compared to pre-procedure sCT. DD and V maps were derived for each patient and depolarized surface areas were compared.
Results: Seven patients (57% Male, Age 61.4 ± 10.3 yrs, AF duration 4.2 ± 2.3 yrs) were enrolled. Complete data sets were collected in 6 subjects. Surface-points must be acquired for at least 30 seconds to achieve a consistent median distance between AcQMap and sCT surfaces. The absolute median distance between surfaces was 2.71 mm. During AF, the mean depolarized area for DD maps was 26.9 cm2, significantly less than for V maps (110.6 cm2, p < 0.001). Overall V:DD ratio was 4.11 for AF.
Conclusions: Real-time U/S based LA reconstruction was rapid and compared favorably to sCT. DD map provides 4.11 times higher resolution than V maps. The combination of CT-quality anatomy and DD mapping opens the possibility to map AF with more precision to identify areas of interest as potential ablation targets.
Author Disclosures: P. Heck: None. P. Neuzil: None. V. Reddy: Research Grant; Significant; Biosense-Webster, Boston Scientific, Coherex, St Jude Medical. Consultant/Advisory Board; Significant; Biosense-Webster, Boston Scientific, Coherex, St Jude Medical. A. Grace: None.
- © 2015 by American Heart Association, Inc.