A novel dual-chamber reference technique to detect premature atrial complexes with non–pulmonary vein foci

Figures

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  Figure 1. Intracardiac recordings show sinus rhythm (yellow arrow) and the earliest activation site of the non–pulmonary vein trigger (pink arrow) in the coronary sinus (CS) proximal location.

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  Figure 2. Representative examples of the dual Intra-Cardiac Pattern Matching algorithm (CARTO 3; Biosense Webster) distinguish sinus rhythm based on unipolar signals recorded by the reference catheter. A: The score of the clinical premature atrial complex (PAC) and sinus rhythm were 1.00 and 0.93 based on unipolar signals recorded by the coronary sinus (CS) catheter only. B: When unipolar electrograms recorded by CS and right atrium (RA) were used as the reference, the scores of the clinical PAC and sinus rhythm were 0.97 and 0.51, respectively. As a result, the electrograms from sinus rhythm were successfully eliminated from local activation time map.

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  Figure 3. Local activation time (LAT) maps created with a single- and dual-reference techniques. A: LAT map created from unipolar signals from the coronary sinus (CS). The earliest activation site (EAS) was located in the left atrial septum that represents propagation from sinus rhythm. B: LAT map created from unipolar signals from the CS and right atrium (RA). The EAS was located in the left atrial inferior septum that represents propagation from clinical premature atrial complex only, excluding propagation from sinus node.