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Repetitive atrial activation during ongoing atrial fibrillation—comparison using different mapping algorithms: preliminary findings

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Abstract

Purpose

Targeting repetitive sources identified during atrial fibrillation (focal impulse and rotor modulation, FIRM) has been used as an ablation strategy using specific mapping tools. Aim of this study was to evaluate FIRM mapped rotors with a new multipolar mapping algorithm.

Methods

Patients with persistent atrial fibrillation undergoing FIRM ablation were included. Mapping of left atrial rotors was performed with a 64-pole basket catheter in conjunction with a specialized phase mapping algorithm. Subsequently, raw signals were analyzed by a novel mapping system (CARTOFINDER™). Comparison of FIRM identified sources with areas of repetitive activation analyzed by CARTOFINDER™ was performed.

Results

Nine patients were included (5 redo procedures; male n = 6; 66.5 ± 8.6 years) and 28 left atrial rotors were compared with the findings of the novel mapping system. CARTOFINDER™ identified repetitive activation patterns in 6 mapping sequences at remote sites (2 rotational patterns, 4 linear activation patterns).

Conclusions

In this comparative preliminary study, two different mapping technologies to detect repetitive atrial activation during ongoing AF were used. Whereas rotational activation was documented using FIRM mapping no corresponding repetitive activation patterns near sites of FIRM-mapped rotor cores were identified using the novel mapping technology even though using the same electrogram characteristics and mapping basket position.

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Authors and Affiliations

  1. Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany

    Philipp Halbfass, Karin Nentwich, Kai Sonne, Karsten Hamm, Sebastian Barth, Franziska Fochler & Thomas Deneke

  2. Department of Cardiology and Angiology, Philipps University Marburg, Marburg, Germany

    Philipp Halbfass

  3. Cardiac Arrhythmia Service, Division of Cardiology, Pulmonology and Vascular Medicine, University Düsseldorf, Medical Faculty, Düsseldorf, Germany

    Patrick Müller

  4. Ruhr-University Bochum, Bochum, Germany

    Andreas Mügge & Thomas Deneke

Authors
  1. Philipp Halbfass
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  2. Patrick Müller
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  3. Karin Nentwich
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  4. Kai Sonne
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  5. Karsten Hamm
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  6. Sebastian Barth
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  7. Franziska Fochler
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  8. Andreas Mügge
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  9. Thomas Deneke
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Corresponding author

Correspondence to Philipp Halbfass.

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Conflict of interest

P. Halbfass has received an educational grant from Boston Scientific and travel grants from Biotronik and BiosenseWebster. P. Müller has received an educational grant from Boston Scientific. T. Deneke has received lecture’s honoraria from TOPERA and travel grants from Biotronik and BiosenseWebster. All other authors have not reported any financial disclosures or conflicts of interest.

Funding

No funding was received for this study.

Ethical approval

The study was approved by the local institutional review board and was carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans.

Informed consent

All patients provided written informed consent regarding the study.

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Halbfass, P., Müller, P., Nentwich, K. et al. Repetitive atrial activation during ongoing atrial fibrillation—comparison using different mapping algorithms: preliminary findings. J Interv Card Electrophysiol 49, 67–74 (2017). https://doi.org/10.1007/s10840-017-0244-8

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  • DOI: https://doi.org/10.1007/s10840-017-0244-8

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