Dispersion electrogram detection with an artificial intelligence software in redo paroxysmal atrial fibrillation ablation

Figures

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  Figure 1. Spatiotemporal dispersion of multipolar electrograms (EGMs), detection with AI software (VX1; Volta Medical, Marseille, France), and catheter ablation. Left panel displays examples of dispersed EGMs from patient 1. EGMs are processed in real time by VX1 system (VX1 interface right panel) on 1.5-second signals and are considered dispersed when they display 1 continuously fractionated electrogram with a cumulative duration longer than 80% of the 1.5-second window. Stable intracardiac atrial dispersed electrograms are identified by VX1 algorithm on each dipole 1-2 to 19-20 (the dipoles schematized in the upper half cycle are blinking red). The lower part of the frame displays the average cycle length as recorded by the reference catheter (R) and the mapping catheter (M).

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  Figure 2. Electroanatomical maps from patients 1 (biatrial, A), 2 (left atrium, B), 3 (biatrial, C), and 4 (biatrial, D). Maps on the left demonstrate dispersion sites, where green points are highly dispersed and white points moderately dispersed. Right-sided maps show the dispersion and pulmonary vein isolation lesion sets. Blue dot in panels B and D shows point where termination of atrial fibrillation occurred.

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  Figure 3. Electroanatomical maps from patient 2. A: Image shows 43 left atrial points (white dots) mapped with the PENTARAY (Biosense Webster, Irvine, CA) and the VX1 (Volta Medical, Marseille, France) system. B: PENTARAY signals in the right carina, with dispersion demonstrated across the PENTARAY splines. PENTARAY 13/14 (white dot with highlighted edge/blue-green electrogram) is at the site of termination during ablation.