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03.07.2020 | MULTIMEDIA REPORT | Ausgabe 2/2021

Journal of Interventional Cardiac Electrophysiology 2/2021

Initial multicenter experience with a new high-density coloring module: impact for complex atrial arrhythmias interpretation

Zeitschrift:
Journal of Interventional Cardiac Electrophysiology > Ausgabe 2/2021
Autoren:
Grégoire Massoullié, Ghassan Moubarak, Olivier Thomas, Antoine Da Costa, Vincent Roger, Julio Justo, Alexis Mechulan, Romain Eschalier, John Silberbauer, Marius Andronache
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s10840-020-00802-1) contains supplementary material, which is available to authorized users.

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Abstract

Background

High-density automated mapping of complex atrial tachycardias (ATs) requires accurate assessment of activation maps. A new local activation display module (HD coloring, Biosense Webster®) provides higher map resolution, a better delineation of potential block reducing color interpolation, and a new propagation display. We evaluated the accuracy of a dedicated local activation display compared with standard algorithm.

Methods

High-density maps from 10 AT were collected with a multipolar catheter and were displayed with standard activation or HD coloring. Six expert operators retrospectively analyzed activation maps and were asked to define (1) the tachycardia mechanism, (2) ablation target, and (3) level of difficulty to interpret those maps.

Results

Using HD coloring, operators were able to reach a correct diagnosis in 93% vs. 63%, p < 0.05 compared to standard activation maps. Time to diagnosis was shorter 1.9 ± 1.0 min vs. 3.9 ± 2.1 min, p < 0.05. Confidence level would have allowed ablation without necessity for entrainment maneuvers in 87% vs. 53%, p < 0.05. Operators would have needed to remap or proceed with multiple entrainments in 3% vs. 13% of cases, p < 0.05. Finally, ablation strategy was more accurately identified in 97% vs. 67%, p < 0.05.

Conclusion

Activation mapping with the new HD coloring module allowed a more accurate, reliable, and faster interpretation of complex ATs mechanisms compared to standard activation maps.

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