Detection of an epicardial accessory pathway using the novel algorithm during ultra-high-density mapping

Figures

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  Figure 1. Electrocardiograms (ECG), activation mapping, and the local electrograms. A: A 12-lead ECG of sinus rhythm showing the intermittent appearance of delta waves. B: Activation mapping and Lumipoint (Boston Scientific, Washington, DC). An activation map illustrating that the activation wavefront just reached the left ventricle via the accessory pathway during sinus rhythm. The area that contained the active electrogram during that time is highlighted by the Lumipoint module as well. Note that both the earliest ventricular activation site and ablation successful site are geographically away from the mitral annulus. Lumipoint allowed visualization of the skip activation over the mitral annulus. The yellow arrow indicates the possible activation propagation along with the accessory pathway. C: Local electrogram of the successful ablation site. The local electrograms of the successful ablation site, mitral annulus, and earliest ventricular activation site are shown in this figure. The blue dashed line indicates the timing of the onset of the QRS wave in lead V4. Note that the accessory pathway (AP) potential was recorded at the same time as that at the successful ablation site and is…