Computer-assisted animation of atrial tachyarrhythmias recorded with a 64-electrode basket catheter.
OBJECTIVE
The aim of this study was to assess the value of a new mapping technique based on computer-assisted animation of multielectrode basket catheter (BC) recordings in patients with atrial arrhythmias.


BACKGROUND
The three-dimensional activation patterns of cardiac arrhythmias are not completely understood owing to limitations of conventional mapping techniques.


METHODS
The study included 32 patients with atrial tachycardia (AT) and 38 patients with atrial flutter (AFL). A software program was developed to analyze the activation patterns based on 56 bipolar electrograms recorded with a 64-electrode BC deployed in the right atrium (RA).


RESULTS
The total time needed for the animation of activation patterns of atrial arrhythmias was 5 +/- 0.8 min. In 22 patients with right AT, the animated maps revealed that arrhythmia was unifocal in 15 patients, multifocal in 2 patients, polymorphic in 4 patients and reentrant in 1 patient. In 10 patients with left AT, breakthroughs on the right side of the septum (2 in 8 patients and 1 in 2 patients) and a left-to-right activation of the RA were demonstrated. In patients with typical AF, the reentrant excitation was a broad activation front with preferential propagation around the tricuspid annulus. In patients with atypical AFL, the reentry circuit involved one of the venae cavae and a line of block located in the posterior wall.


CONCLUSIONS
The computer-assisted animation of multiple electrograms recorded with a BC is a valuable mapping tool that delineates the three-dimensional activation patterns of various atrial arrhythmias. The technique is appropriate for complex, short-lived or unstable arrhythmias.
Zrenner
B
B
Deutsches Herzzentrum München and Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. Zrenner@dhm.mhn.de
Ndrepepa
G
G
Schneider
M
M
Karch
M
M
Hofmann
F
F
Schömig
A
A
Schmitt
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001282:Atrial Flutter / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D018780:Body Surface Potential Mapping / Q000379:methods*; D006328:Cardiac Catheterization / Q000295:instrumentation*; D017115:Catheter Ablation; D003196:Computer Graphics; D003198:Computer Simulation; D004566:Electrodes; D005260:Female; D006339:Heart Rate; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013612:Tachycardia, Ectopic Atrial / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery