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Compass Mapping, Double Potentials, Activation Patterns Can Identify and Track Rotational Activity Sites in the Left
Donald S Rubenstein1, Hang Yin2, Sana A Azami3
1Greenville Health System, Greenville Health System, 701 Grove Road, Greenville, SC 29605.
Journal of Atrial Fibrillation
|December 4, 2018
Summary
Compass mapping with double potentials (DPs) allows regional identification of rotational activity. Simultaneous recordings precisely track the time, location, and path of these electrical rotors during atrial fibrillation.
Area of Science:
- Electrophysiology
- Cardiac Arrhythmias
Background:
- Rotational electrical circuits in the atria can manifest as double potentials (DPs).
- Direct electrical tracking of these rotors was previously considered unfeasible.
Purpose of the Study:
- To demonstrate regional identification of rotational activity using compass mapping.
- To establish signature recording patterns for precise tracking of rotational mechanisms through combined mapping techniques.
Main Methods:
- Observational study in 20 patients with persistent atrial fibrillation.
- Utilized compass mapping (wide cross-circle electrode pairing) and standard bipolar/unipolar recordings.
- Analyzed double potentials (DPs) and wavefront patterns at 12 left atrial sites.
Main Results:
- Identified four wavefront patterns: DPs, peripheral waves (PWs), distal peripheral waves, and fibrillatory activity.
- DPs showed significantly shorter cycle lengths than PWs in most analyzed sites.
- Detailed analysis revealed consistent patterns at transitions between wave types, including reversed activation and a Doppler effect-like phenomenon.
Conclusions:
- Compass mapping with DPs enables regional assessment of atrial rotational activity.
- Combined recording techniques accurately determine the time, location, and path of rotational mechanisms.
- This method allows for precise electrical tracking of rotors during atrial fibrillation.
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