VERSA: Omnipolar vector mapping from arbitrarily positioned electrodes.

Area of Science:

• Electrophysiology
• Medical device technology
• Computational cardiology

Background:

• Accurate arrhythmia propagation assessment is crucial for identifying ablation targets.
• Current methods using local activation time (LAT) are limited by variability, catheter orientation, and sampling density.

Purpose of the Study:

• Extend LAT-independent omnipolar technology (OT) to catheters with diverse electrode arrangements.
• Compare omnipolar estimates with LAT-derived metrics.
• Develop a weighted resampling algorithm for robust wavefront propagation visualization.

Main Methods:

• Computed omnipolar estimates of conduction velocity (CV), activation direction (AD), and voltage from electroanatomic mapping data.
• Compared omnipolar estimates to conventional LAT-based analogs.
• Developed and assessed the Vector Estimation, Resampling, and Smoothing Algorithm (VERSA) for visualization.

Main Results:

• Omnipolar CV estimates were higher than LAT-based CV; AD differences were negligible.
• Omnipolar voltages were significantly higher than bipolar voltages.
• VERSA maps intuitively visualized wavefront propagation, conduction block, and reentry patterns, agreeing with conventional maps.

Conclusions:

• Omnipolar technology extended to arbitrary electrode arrangements elucidates wavefront propagation in reentrant tachycardias without LAT.
• VERSA maps provide clear visualizations, aiding interpretation of complex arrhythmias.
• These advancements can facilitate more effective ablation strategies.