A novel intra-operative, high-resolution atrial mapping approach

Area of Science:

• Cardiology
• Electrophysiology
• Medical Technology

Background:

• Atrial fibrillation (AF) remains a significant clinical challenge requiring effective diagnostic tools.
• Current methods for intra-operative atrial mapping may lack the necessary resolution or efficiency.
• Identifying the specific sources and substrates of AF is crucial for targeted treatment.

Purpose of the Study:

• To demonstrate a new technique for extensive, high-resolution intra-operative atrial mapping.
• To facilitate the precise localization of atrial fibrillation (AF) sources.
• To identify the substrate that perpetuates AF for improved therapeutic strategies.

Main Methods:

• Utilized an 8x24 electrode array (2-mm inter-electrode distance) for epicardial atrial mapping.
• Recorded unipolar electrograms during sinus rhythm and induced AF prior to extra-corporeal circulation.
• Employed a computerized mapping system with real-time visualization for quality assurance.

Main Results:

• The technique was successfully applied in 168 adult patients undergoing cardiac surgery.
• The mean mapping procedure duration was 9 ± 2 minutes.
• No complications related to the mapping procedure were observed.

Conclusions:

• Introduced the first high-resolution (≥1728 sites) epicardial atrial mapping approach.
• The rapid 9±2 minute procedure time makes it clinically feasible.
• This technique has the potential to individualize AF diagnosis and therapy by identifying critical areas.