Validation Of An Algorithm For Automatic Arrhythmia Recognition And 3D
Mapping In A Porcine Model
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.