Point density exclusion mapping-A useful tool for mapping arrhythmias arising from the endocavitary structures

Area of Science:

• Cardiology
• Electrophysiology
• Medical Imaging

Background:

• Ventricular tachycardia (VT) originating from papillary muscles and endocavitary structures often requires specialized ablation guidance.
• Intracardiac echocardiography (ICE) is preferred for such procedures but faces limitations due to cost, availability, and operator expertise.
• Current limitations of ICE hinder its widespread adoption in routine catheterization laboratory settings.

Purpose of the Study:

• To introduce and describe Point Density Exclusion (PDX) mapping as a practical alternative for mapping VT from endocavitary structures.
• To demonstrate the feasibility and application of PDX mapping in a clinical case.
• To highlight PDX mapping as a cost-effective and accessible technique for electroanatomical mapping.

Main Methods:

• Utilized routine electroanatomical mapping systems.
• Implemented Point Density Exclusion (PDX) mapping technique.
• Described the procedural steps for performing PDX mapping in a case of VT.

Main Results:

• PDX mapping successfully identified the origin of VT from an endocavitary structure.
• The technique proved to be simple and did not require additional equipment beyond standard electroanatomical mapping tools.
• The case report illustrates the practical application and effectiveness of PDX mapping.

Conclusions:

• PDX mapping is a valuable, low-cost technique for mapping arrhythmias originating from endocavitary structures, including papillary muscles.
• Its simplicity and reliance on standard equipment make it widely applicable where ICE is not feasible.
• This method enhances accessibility to effective VT ablation strategies.