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Creation of sinus rhythm and paced maps using a single acquisition step: the “one acquisition-two maps” technique—a feasibility study

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

Scars and abnormal electrograms may significantly differ according to the activation wavefront. We propose a new fast technique for reliable comparison between sinus rhythm and ventricular pacing using a single map acquisition and the Rhythmia™ 3D mapping system.

Methods

A special programming of the external stimulator was assuring full stable regular paced-beat bigeminy during spontaneous rhythm. A first map was acquired for the spontaneous cardiac beat. Then the window of detection was moved to the following paced beat, and a second map was available after recalculation by the system, depicting activation and voltage of the paced cardiac beat at the same locations, with an exactly the same number of beats in both maps.

Results

Thirty patients with structural heart disease referred for ablation of ventricular tachycardia underwent this protocol, who were compared with 19 similar patients undergoing repeated maps. Duration of the mapping was significantly shorter compared to controls (34 ± 12 vs 57 ± 14 min, p < 0.0001) without differences in the number of electrograms (6978 ± 7067 vs 9554 ± 4424 for sinus rhythm map and 6610 ± 7240 vs 7783 ± 3804 for paced map, p = ns for both). The technique cannot be completed in five patients (17%), because of arrhythmogenicity, mechanical right bundle branch block, hemodynamical impairment, or bradycardia.

Conclusion

We propose a novel technique for performing maps during sinus rhythm and ventricular pacing using a single acquisition. Beside time saving, this will allow more strict comparisons between different activation wavefronts.

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Authors and Affiliations

  1. Department of Cardiology, University Hospital Rangueil, 31059, Toulouse, Cedex 09, France

    Quentin Voglimacci-Stephanopoli, Anne Rollin, Pierre Mondoly, Franck Mandel & Philippe Maury

  2. Bordeaux University Hospital, Bordeaux, France

    Frederic Sacher & Pierre Jaïs

  3. LIRYC Institute/INSERM 1045, Bordeaux University, Bordeaux, France

    Frederic Sacher & Pierre Jaïs

  4. Papworth Hospital NHS Foundation Trust, Cambridge, UK

    Claire Martin

  5. University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Christian Meyer

  6. Freeman Hospital, Newcastle upon Tyne, UK

    Ruairidh Martin

  7. Boston Scientific, Voisins-le-Bretoneux, France

    Stefano Capellino & Maud Tabuteau

  8. Unité Inserm U 1048, Toulouse, France

    Philippe Maury

Authors
  1. Quentin Voglimacci-Stephanopoli
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  2. Frederic Sacher
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  3. Claire Martin
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  4. Christian Meyer
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  5. Ruairidh Martin
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  6. Anne Rollin
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  7. Stefano Capellino
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  8. Pierre Mondoly
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  9. Franck Mandel
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  10. Pierre Jaïs
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  11. Maud Tabuteau
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  12. Philippe Maury
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Corresponding author

Correspondence to Philippe Maury.

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Conflict of interest

M Tabuteau and S Capellino are employed by Boston Scientific. R Martin: travel grant from Boston Scientific and Abbott. C Martin received honoraria from Boston Scientific. C Meyer is a consultant for Biotronik, Biosense Webster, Boston Scientific, and Boston Scientific. F Sacher received consulting fees and speaking honorarium from Boston Scientific, Biosense Webster and Abbott. None for other authors.

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Voglimacci-Stephanopoli, Q., Sacher, F., Martin, C. et al. Creation of sinus rhythm and paced maps using a single acquisition step: the “one acquisition-two maps” technique—a feasibility study. J Interv Card Electrophysiol 61, 235–243 (2021). https://doi.org/10.1007/s10840-020-00793-z

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  • DOI: https://doi.org/10.1007/s10840-020-00793-z

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