ABSTRACT
Introduction: Atrial tachycardias (AT) can present multiple
sites of origin or circuits which complicates mapping, requiring
creation of separate activation maps per site.
Objective: To evaluate the Intra-Cardiac Pattern Matching
(ICPM) software that automatically detects and assigns different
arrhythmia sources to separate 3D activation maps in a porcine model.
Methods: To simulate different ATs, continuous pacing at same
cycle length was performed from 2-3 right atrial (RA) sites (2 screw-in
leads and mapping catheter) for 60-90 seconds before alternating. RA was
continuously mapped with a 48-electrode high-density mapping catheter
(Octaray). The operator manually switched and added points to the
respective maps when the AT changed. Conversely, the ICPM algorithm
(Carto Mapping system) automatically assigned each beat to its
respective map. Pacing electrodes were repositioned to create a second
set of maps. Offline analysis (manual and automatic maps) was performed
comparing local activation times (LAT) and mesh coloring values of
adjacent points (<5 mm apart). Differences <10 msec
were considered a match.
Results: Twenty-three different pacing sites were analyzed in 6
swine with 1 manual/1 automatic map per site (46 maps); and 40,176
points were compared (manual and automatic). Individual LATs for manual
and automatic maps were compared and matched 91.2% of the time
(variance of <10 ms). Mesh coloring values matched using the
same criteria.
Conclusion: The ICPM algorithm accurately identified changing
atrial activation sites and assigned points to appropriate maps
>90% of the time compared to manual acquisition.