Visualization of residual gaps after linear ablation using the LUMIPOINT^TM module: A case report

Area of Science:

• Electrophysiology
• Cardiac Mapping

Background:

• Macroreentrant atrial tachycardias (ATs) with epicardial conduction can appear as pseudo-focal ATs on 3-D mapping.
• The Rhythmia mapping system's LUMIPOINT module highlights electrograms (EGMs) based on a confidence slider (CS).

Observation:

• Lowering the CS (L-CS) can reveal previously undetected EGMs, potentially visualizing the critical isthmus of pseudo-focal ATs.
• In three cases of pseudo-focal AT post-linear ablation, the L-CS method was applied by adjusting the LUMIPOINT activation window and gradually decreasing the CS.
• Highlighted areas before and after the ablation line expanded and fused, revealing fragmented, low-voltage EGMs at the fusion sites.

Findings:

• The L-CS method successfully visualized residual gaps and identified critical isthmuses in pseudo-focal ATs.
• Single-shot ablation at the identified sites terminated the targeted ATs in all cases.

Implications:

• The L-CS method offers a valuable tool for improving the accuracy of ablation targeting in complex atrial tachycardias.
• This technique enhances the visualization of critical isthmuses, potentially improving procedural outcomes for pseudo-focal ATs.