A Novel Wave-speed Mapping Method for Visualizing Accessory Pathways in Wolff-Parkinson-White Syndrome

Area of Science:

• Cardiology
• Electrophysiology
• Medical Technology

Background:

• Catheter ablation (CA) is a primary treatment for symptomatic Wolff-Parkinson-White syndrome.
• Three-dimensional (3D) mapping systems are crucial for identifying accessory pathways (APs).

Purpose of the Study:

• To develop and evaluate a novel wave-speed mapping (WSM) method for locating APs.
• To assess the efficacy of WSM in guiding CA and its impact on ablation outcomes.

Main Methods:

• Compared WSM with local activation time (LAT) mapping in 19 patients with atrioventricular reciprocating tachycardia.
• Analyzed the correlation between WSM's "high-speed islets" and successful ablation sites.
• Median mapping points: 1451; Median mapping time: 14.6 minutes.

Main Results:

• All 20 APs were successfully eliminated using WSM-guided ablation.
• 55% of APs were ablated successfully on the first attempt.
• WSM identified significantly narrower AP widths compared to LAT mapping (5.8 mm vs. 10.4 mm).
• No supraventricular tachycardias recurred during a mean follow-up of 13.1 months.

Conclusions:

• WSM is an effective novel mapping technique for visualizing APs as "high-speed islets".
• WSM facilitates more precise ablation site targeting compared to traditional LAT mapping.
• WSM-guided CA demonstrates high success rates and favorable long-term outcomes.