Validation of the Noncontact Mapping System in the Left Atrium During Permanent Atrial Fibrillation and Sinus Rhythm

• Published in: Journal of the American College of Cardiology 2006-08, Vol.48 (3), p.485-491
• Main Authors: Earley, Mark J., Abrams, Dominic J.R., Sporton, Simon C., Schilling, Richard J.
• Format: Article
• Language: English
• Subjects: Adenosine; Adult; Atrial Fibrillation - diagnosis; Atrial Fibrillation - physiopathology; Atrial Function, Left; Biological and medical sciences; Cardiac arrhythmia; Cardiac dysrhythmias; Cardiology; Cardiology. Vascular system; Catheters; Electrodes; Electrophysiologic Techniques, Cardiac - standards; Female; Heart; Heart Block - chemically induced; Heart Block - physiopathology; Heart Rate; Humans; Male; Medical sciences; Middle Aged; Sinuses; Studies; User-Computer Interface; Veins & arteries
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2006.04.069

Validation of the Noncontact Mapping System in the Left Atrium During Permanent Atrial Fibrillation and Sinus Rhythm Mark J. Earley, Dominic J. R. Abrams, Simon C. Sporton, Richard J. Schilling Noncontact mapping (NCM) is ideal for mapping atrial fibrillation (AF). This study aimed to validate NCM in human left atrium (LA) during sinus rhythm (SR) and AF. In 22 patients, contact and virtual electrograms were simultaneously around the LA and algorithms applied to compare their morphology, timing, and amplitude. The median morphology correlation was 0.81 in SR and 0.72 in AF. During SR at endocardial sites >40 mm from the array, there was reduction in amplitude of virtual electrograms and deterioration of correlation with contact electrograms. Noncontact mapping can be performed in human LA providing the endocardium is close to the array. The aim of this study was to validate noncontact mapping (NCM) in the left atrium (LA) during sinus rhythm and atrial fibrillation (AF). Understanding the mechanisms of AF is crucial to the development of novel and effective treatments. Noncontact mapping records global electrical activation simultaneously and therefore has the potential to elucidate these mechanisms. Patients underwent catheter ablation of permanent AF guided by NCM. Virtual and contact unipolar electrograms were recorded simultaneously during sinus rhythm and AF from sites spanning the LA and their morphology, amplitude, and timing were compared. The impact of distance from the array to the endocardial surface and electrogram amplitude were analyzed. A total of 22 patients age 52 ± 9 (mean ± SD) years were studied. During sinus rhythm, the median (range) morphology correlation and timing difference between contact and virtual atrial electrograms were 0.81 (0.27 to 0.98) and 4.2 (0 to 18.3) ms, respectively. These results were significantly worse than the corresponding far field individual ventricular electrograms; 0.91 (0.53 to 1.0) and 1.7 (0 to 18.3) ms (p < 0.001). For endocardial sites >40 mm from the array, the correlation was significantly worse than sites