DISCUSSION
This study, in a controlled in-vivo environment, showed that the novel
ICPM software was capable of accurately recognizing and mapping changing
atrial foci. Whereas the operator was notified when the pacing site
changed and switched maps accordingly, the software determined that the
pacing site had changed on its own. Resultant maps were visually
superposable. Quantitatively, local activation times and mesh vertices
showed consistent matches >90% of the time. Pacing
distances as close as 10 mm were assessed, and cycle lengths were kept
constant to test the robustness of the system for distinguishing subtle
differences in activation sites. This type of autonomous mapping
capability could be of great benefit when targeting changing arrhythmia
types, particularly in aforementioned conditions like atrial
tachycardia, congenital heart disease and ventricular arrhythmias
[7-9]. Additional advantages include automated filtering of
mechanically induced ectopic activation that could introduce
inaccuracies with manual mapping, particularly when cycle lengths are
not radically different. Moreover, automated mapping can identify slight
changes in signal morphology resulting from movements of the reference
catheter that can otherwise go undetected.