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Remote Magnetic Navigation for Accurate, Real-time Catheter Positioning and Ablation in Cardiac Electrophysiology Procedures

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Published on: April 21, 2013

Comparison of first deflection annotation algorithm and near-field annotation algorithm in premature ventricular

Natnicha Pongbangli¹, Akiko Ueda², Noriko Matsushita Nonoguchi²

¹Department of Cardiovascular Medicine, Kyorin University School of Medicine, Mitaka, Japan; Division of Cardiology, Department of Internal Medicine Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand.

|January 16, 2026

Summary

First Deflection (FD) detection identifies earlier activation times, while Near-Field (NF) detection captures higher frequencies during premature ventricular complex (PVC) ablation. Closer spatial correlation between FD and NF predicts more successful PVC elimination.

Keywords:

Catheter ablation Electroanatomic mapping First deflection mapping Near-field mapping Premature ventricular complex (PVC)

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Area of Science:

Electrophysiology
Cardiac Mapping

Background:

Accurate identification of the earliest activation site is crucial for successful catheter ablation of premature ventricular complexes (PVCs).
Current mapping techniques require optimization for precise localization.

Purpose of the Study:

To compare the efficacy of First Deflection (FD) and Near-Field (NF) detection using Turbomap on the Ensite X system for identifying earliest activation sites in PVC ablation.
To assess differences in local activation time (LAT), peak frequency, activation area, and spatial distance between FD and NF detection.

Main Methods:

Retrospective analysis of 59 patients undergoing first-time PVC ablation.
Remapping using Turbomap to extract FD and NF parameters at earliest activation sites.
Comparison of ΔLAT, Δ peak frequency, Δ activation area, and spatial distance between techniques.

Main Results:

FD detection yielded significantly earlier LAT compared to NF detection.
NF detection identified significantly higher peak frequencies than FD detection.
A shorter spatial distance between FD and NF earliest activation sites correlated with successful PVC elimination within two ablation attempts.

Conclusions:

FD detection is superior for identifying earlier activation times, while NF detection excels at capturing higher-frequency signals.
The spatial proximity of FD and NF earliest activation sites may predict ablation success.
Mapping parameters did not significantly differ across PVC origin or ablation strategy groups, but spatial correlation is key.