New technologies in electroanatomic mapping for a better mechanism
characterization of supraventricular tachyarrhythmias
Abstract
Background Provide a brief overview of recent technological
advances that can potentially give information for treatment of
different kind of arrhythmias. Methods In this report, we
describe the features of Omnipolar technology (OT) using high density
mapping catheter and we report five different scenario in which this new
tool can give some important information to understand arrhythmia’s
substrate and guide the treatment. OT combine three unipolar and two
bipolar signals and provides maximum voltage regardless of
electrode-wavefront orientation, local wavefront activation direction
and local measurements of wave speed: it allow to create a velocity map.
Results OT has been used to study different types of
supraventricular tachycardias. Regarding reentry tachycardias, velocity
map has allowed the characterization and definition of the impulse
velocity along the dual nodal pathway and the accessory pathways (AP).
As regards atrial flutter, it has successfully allowed the definition of
the slowest zone of the critical isthmus and radiofrequency (RF)
delivery at that point resulted in termination of the arrhythmia. During
mapping of the left atrium in sinus rhythm, the velocity map allowed the
identification of the course of the Bachmann’s bundle, which could
potentially play a role during the ablation of persistent atrial
fibrillation (AF). Conclusion OT and velocity map offer
significant advantages in the management of challenging arrhythmias, and
can potentially improve the efficacy of the treatment of some
arrhythmias such as atrial flutter and AF.