High-density and high coverage composite mapping of repetitive atrial activation patterns

Area of Science:

• Cardiovascular Electrophysiology
• Medical Imaging and Mapping

Background:

• Repetitive atrial activation patterns (RAAPs) in atrial fibrillation (AF) suggest localized mechanisms maintaining the arrhythmia.
• Current electroanatomical mapping systems face limitations in spatial coverage versus electrode density for analyzing RAAPs.
• A novel technique is proposed to overcome these limitations by creating composite maps from sequential recordings.

Purpose of the Study:

• To develop and validate a method for constructing composite electroanatomical maps from spatially overlapping sequential recordings.
• To assess the feasibility and accuracy of reconstructing RAAPs using this composite mapping technique.
• To evaluate the potential of composite maps in understanding AF mechanisms and informing ablation planning.

Main Methods:

• High-density epicardial contact mapping was performed in goats with sustained AF.
• Sequential recordings were segmented into overlapping regions to mimic composite mapping.
• Repetitive atrial activation patterns (RAAPs) were detected using recurrence plots and cross-recurrence analysis.

Main Results:

• Composite maps were successfully generated in 75% of cases with a quality score of 0.86±0.21.
• Reconstruction success was influenced by the area of the RAAP.
• Map quality showed a weak correlation with RAAP repetition and was independent of atrial side or AF duration.

Conclusions:

• Constructing composite electroanatomical maps from overlapping sequential recordings is a feasible approach.
• This technique can effectively analyze repetitive atrial activation patterns during atrial fibrillation.
• Composite maps hold significant potential for improving ablation planning in AF patients.