Novel mapping techniques for ablation of non‐pulmonary vein foci using complex signal identification

Figures

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  FIGURE 1. Mapping was performed during sinus rhythm, with complex signal identification (CSI) represented by green tags. CSI distribution varied across voltage zones, transitioning from high to low voltage. The area of atrial fibrillation (AF) firing is indicated by blue tags, corresponding to local potentials exhibiting fractionation, with a CSI score of 9.8.

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  FIGURE 2. Simultanouesly, the Libero catheter, positioned on the contralateral right atrium septum, showed delayed activation. This confirmed that the blue‐tagged point was a non‐pulmonary vein trigger. (A) Atrial fibrillation was induced in this region, promoting placement of the Octaray catheter at the site. The earliest activation was recorded in electrode D3,4 of the Octaray catheter (B).

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  FIGURE 3. The ablation point is highlighted in this image. Pulmonary vein isolation and cavotricuspid isthmus ablation were performed. The proximal CSI region of the right pulmonary vein and the contralateral right atrium were ablated, and atrial fibrillation could no longer be induced.