Novel automated point collection software facilitates rapid, high‐density electroanatomical mapping with multiple catheter types

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Electroanatomical mapping, which has become an essential tool for the ablation of cardiac arrhythmias, is based on simultaneous recording of spatial information and electrical activity from catheter‐mounted electrodes.1 Conventional mapping technology requires that the operator manually move a roving catheter within the heart and collect individual map points after direct inspection of the electrograms.4 Although this process produces accurate maps of cardiac chambers, map acquisition can be labor intensive and time consuming. Creating high‐density electroanatomic maps (EAMs) of intermittent phenomena, such as premature atrial or ventricular contractions, can be particularly challenging.
High‐density mapping has the potential to facilitate a more detailed understanding of the physical substrate of arrhythmias.7 Recent advances in catheter technology allow for collection of information from multiple points in space simultaneously, thus facilitating an increase in the rate of point collection. By increasing the speed of data acquisition, this technology makes procurement of more detailed EAMs in the clinical setting more practical. Several catheter platforms that facilitate rapid mapping have been reported, including noncontact mapping catheters and contact mapping with catheters containing multi‐electrode arrays. Non‐contact mapping allows for rapid chamber mapping, but can be associated with spatial artifacts, and is not in common clinical use.10 Contact mapping with multielectrode catheters that allow for collection of multiple points in space simultaneously have been described.7 Although previously described multielectrode catheters can facilitate rapid point collection, these catheters are sometimes bulky and may not be applicable to all mapping and ablation situations. In addition, some of these multielectrode catheters are only compatible with purpose‐built mapping software, which may further restrict their use.
In this report, we describe a novel mapping system that performs two functions that facilitate rapid construction of high‐density EAMs: (1) collection of map data from multiple points in space simultaneously and (2) processing of surface and intracardiac electrocardiograms (EGMs) in order to accept or reject beats without direct input from the operator. The open platform software of this mapping system is compatible with multiple catheters, and therefore affords the operator greater flexibility when choosing the catheter most appropriate for a given clinical application. The purpose of the experiments described in this report was to determine the feasibility of using this signal processing software to construct EAMs without direct operator evaluation of EGMs during point collection.
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