Noncontact mapping of atrial arrhythmias may be superior to contact mapping
In a small study, a noncontact mapping algorithm was faster and better identified complex atrial arrhythmias compared with contact mapping.
The study included 31 patients who had preexisting atrial tachycardias or atrial tachycardia that developed during atrial fibrillation catheter ablation procedures. All underwent ablation guided by the noncontact mapping system (SuperMap algorithm and AcQMap catheter, Acutus Medical) and 19 also underwent concurrent contact mapping (Ensite Precision, Abbott).
The outcomes of interest included time taken to obtain diagnostic maps, number of electrogram points and accuracy as determined against the confirmed arrhythmia diagnosis from mapping findings, response to entrainment and response to ablation.
In the noncontact mapping procedures, median acquisition time was 314 seconds and median number of electogram points used per map was 5,399, Michael T.B. Pope, BM, electrophysiology research fellow in the department of cardiology at Oxford University Hospitals NHS Foundation Trust, and colleagues wrote.
Mean total acquisition time was 394 seconds for the noncontact system and 611 seconds for the contact system (difference, 217 seconds; 95% CI, 116-318; P < .0005), according to the researchers.
The mean number of electogram points used per map was 7,351 for the noncontact system and 3,620 for the contact system (difference, 3,731; 95% CI, 2,073-5,388; P < .0005), Pope and colleagues wrote.
The accuracy rate was numerically higher for the noncontact system compared with the contact system (92% vs. 85%; P = .4805), according to the researchers.
“The bar against which novel methods of electroanatomic mapping are to be compared is ... extremely high and the accuracy of the SuperMap non-contact algorithm demonstrated in this study compared extremely favorably with that seen using contemporary high-density contact mapping,” Pope and colleagues wrote. “SuperMap non-contact charge density mapping is a rapid and reliable approach to guide the ablation of complex [atrial tachycardias]. Panoramic mapping may provide further opportunities to understand complex arrhythmia mechanisms, but further work is required to fully understand the analysis of charge density signals in assessing the atrial substrate.”
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