Body Surface Mapping to Guide Atrial Fibrillation Ablation

Abstract

Atrial fibrillation (AF) is the most common rhythm disorder, and is strongly associated with thromboembolic events and heart failure. Over the past decade, catheter ablation of AF has advanced considerably with progressive improvement in success rates. However, interventional treatment is still challenging, especially for persistent and long-standing persistent AF. Recently, AF analysis using a non-invasive body surface mapping technique has been shown to identify localised reentrant and focal sources, which play an important role in driving and perpetuating AF. Non-invasive mapping-guided ablation has also been reported to be effective for persistent AF. In this review, we describe new clinical insights obtained from non-invasive mapping of persistent AF to guide catheter ablation.

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation

“… 224 , 225 Another system that has been developed to noninvasively map rotational activity is the ECGI mapping system. 221 , 570 , 571 , 572 This system utilizes a multielectrode vest that records 224 body surface ECGs; electrical potentials, electrograms, and isochrones are then reconstructed on the heart’s surface using geometrical information from computed tomography (CT). A mathematical algorithm combines the body surface potentials recorded by the electrodes and the geometric information provided by CT and solves the electrocardiographic inverse problem in order to noninvasively obtain estimated epicardial electrograms.…”

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary

“… IIb B-R 19 , 20 , 195 , 196 , 197 , 212 , 213 , 214 , 215 , 216 , 217 , 218 , 219 , 220 The usefulness of ablation of rotational activity as an initial or repeat ablation strategy for persistent and long-standing persistent AF is not well established. IIb B-NR 221 , 222 , 223 , 224 , 225 , 226 , 227 , 228 , 229 , 230 , 231 , 232 , 233 , 234 , 235 , 236 , 237 , 238 , 239 , 240 , 241 The usefulness of ablation of autonomic ganglia as an initial or repeat ablation strategy for paroxysmal, persistent, and long-standing persistent AF is not well established. IIb B-NR 19 , 89 , 242 , 243 , 244 , 245 , 246 , 247 , 248 , 249 , 250 , 251 , 252 , 253 , …”

Real-Time Rotational Activity Detection in Atrial Fibrillation

“…These works detect and characterize drivers using imaging of complex activation patterns in real-time. Specific examples are the invasive systems RhythmView (Topera) (Narayan et al, 2012 ), CartoFinder (Biosense Webster) (Daoud et al, 2017 ), AcQMap (Acutus Medical) (Grace et al, 2017 ; Martin et al, 2017 ), and non-invasive CardioInsight ECVUE (Medtronic) (Yamashita et al, 2015 ).…”