title: Repetitive atrial activation during ongoing atrial fibrillation-comparison using different mapping algorithms: preliminary findings.
abstract: OBJECTIVE
  Targeting repetitive sources identified during atrial fibrillation (focal impulse and rotor modulation, FIRM) has been used as an ablation strategy using specific mapping tools. Aim of this study was to evaluate FIRM mapped rotors with a new multipolar mapping algorithm.
  
  
  METHODS
  Patients with persistent atrial fibrillation undergoing FIRM ablation were included. Mapping of left atrial rotors was performed with a 64-pole basket catheter in conjunction with a specialized phase mapping algorithm. Subsequently, raw signals were analyzed by a novel mapping system (CARTOFINDER™). Comparison of FIRM identified sources with areas of repetitive activation analyzed by CARTOFINDER™ was performed.
  
  
  RESULTS
  Nine patients were included (5 redo procedures; male n = 6; 66.5 ± 8.6 years) and 28 left atrial rotors were compared with the findings of the novel mapping system. CARTOFINDER™ identified repetitive activation patterns in 6 mapping sequences at remote sites (2 rotational patterns, 4 linear activation patterns).
  
  
  CONCLUSIONS
  In this comparative preliminary study, two different mapping technologies to detect repetitive atrial activation during ongoing AF were used. Whereas rotational activation was documented using FIRM mapping no corresponding repetitive activation patterns near sites of FIRM-mapped rotor cores were identified using the novel mapping technology even though using the same electrogram characteristics and mapping basket position.
authors.affiliation: Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany. halbfass@gmx.net.|Department of Cardiology and Angiology, Philipps University Marburg, Marburg, Germany. halbfass@gmx.net.
authors.forename: Philipp
authors.identifier: http://orcid.org/0000-0002-4291-2417
authors.initials: P
authors.lastname: Halbfass
authors.affiliation: Cardiac Arrhythmia Service, Division of Cardiology, Pulmonology and Vascular Medicine, University Düsseldorf, Medical Faculty, Düsseldorf, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Müller
authors.affiliation: Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Nentwich
authors.affiliation: Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Sonne
authors.affiliation: Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany.
authors.forename: Karsten
authors.initials: K
authors.lastname: Hamm
authors.affiliation: Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Barth
authors.affiliation: Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Fochler
authors.affiliation: Ruhr-University Bochum, Bochum, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mügge
authors.affiliation: Heart Center Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Germany.|Ruhr-University Bochum, Bochum, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Deneke
mesh_terms: D000368:Aged; D000465:Algorithms; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology*; D018780:Body Surface Potential Mapping / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D010865:Pilot Projects; D012008:Recurrence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
keywords: Atrial fibrillation; FIRM; Focal impulse; Rotor