The omnipolar mapping technology—a new mapping tool to overcome “bipolar blindness” resulting in true high-density maps

Fig. 1. Electrode configuration and voltage points in HDW and OT configuration. Electrode configuration on the HD Grid catheter is displayed for HD wave SolutionTM (A) and EnsiteTM Omnipolar (B, C). A In HD wave configuration, the Best Duplicate algorithm choses the local bipole with the higher voltage. B In omnipolar configuration, local omnipoles are created that lead to a total of 36 mapping points. C Local omnipoles are created inside of a triangle formed by a clique of three adjacent electrodes

Fig. 2. Substrate map of the LA in the area of PV gaps in OT and SD configuration. Atrial substrate maps of the LA displaying PV gaps around the right pulmonary veins (A) and left pulmonary veins (B). The displayed substrate maps have been performed using either OT settings (left) or SD settings (right). Scar threshold is set to 0.1 mV as used in many centers for demonstration purposes

Fig. 3. Mapping data of atrial maps. Line graphs displaying the amount of collected points (A) and voltage (B) of atrial maps for standard configuration (SD), HD wave, and omnipolar technology (OT). **** p < 0.0001

Fig. 4. Substrate map of the LA in the area of a PV gap and associated EGMs. Substrate map of the LA at the site of a PV gap. The map has been performed using OT. The associated EGMs at the identified location of the PV gap are shown on the right (red box), calculated by OT and HDW. Amplitudes of the local EGMs around the gap site are higher in OT configuration vs. HDW configuration (0.62 mV vs. 0.28 mV), as visualized in the green boxes

Fig. 5. Mapping data of ventricular maps. Line graphs displaying the amount of collected points (A) and voltage (B) of ventricular maps for standard configuration (SD), HD wave, and omnipolar technology (OT). **** p < 0.0001

Fig. 6. Substrate map of the posterior LV. Substrate mapping in the posterior LV using HDW and OT configuration. The OT map detects an area as viable myocardium that has been detected as scar in HDW configuration. The same voltage settings were used