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A novel mapping technique to detect non–pulmonary vein triggers: A case report of self- reference mapping technique  Yasuharu Matsunaga-Lee, MD, Yuzuru.

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Presentation on theme: "A novel mapping technique to detect non–pulmonary vein triggers: A case report of self- reference mapping technique  Yasuharu Matsunaga-Lee, MD, Yuzuru."— Presentation transcript:

1 A novel mapping technique to detect non–pulmonary vein triggers: A case report of self- reference mapping technique  Yasuharu Matsunaga-Lee, MD, Yuzuru Takano, MD  HeartRhythm Case Reports  Volume 4, Issue 1, Pages (January 2018) DOI: /j.hrcr Copyright © 2017 Heart Rhythm Society Terms and Conditions

2 Figure 1 Theoretical illustration of self-reference mapping. A: A non–pulmonary vein trigger is considered to conduct centrifugally. The earliest activation site of the PentaRay catheter, which is located far from the trigger, should be one of the outer electrodes (1-2, 5-6, 9-10, 13-14, 17-18). B: The PentaRay catheter is moved to the earlier activation site and placed including the previous earliest site, which is used as the reference for the next trigger mapping method. C: After several mapping iterations, one of the inner electrodes (3-4, 7-8, 11-12, 15-16, 19-20) of the PentaRay catheter can record the earliest activation site. It means that activation of all the outer electrodes is late. D: When the earliest activation tags are concentrated in a small area, the area is the origin of the trigger. HeartRhythm Case Reports 2018 4, 26-28DOI: ( /j.hrcr ) Copyright © 2017 Heart Rhythm Society Terms and Conditions

3 Figure 2 Steps of self-reference mapping. A: PEN was located at the low left atrial septum side. The earliest activation site of the non-PV trigger was PEN The red tag was placed at PEN B: PEN was moved to a higher position including the previous red tag. The earliest activation sites of the next non-PV trigger were PEN and PEN The yellow tag was placed at PEN 15-16, and the red tag was placed at PEN C: PEN was moved to the anterior position. The earliest activation site of the next non-PV trigger was PEN The yellow tag was placed at PEN The earliest tags obtained by inner electrodes were concentrated in a small area. The area was supposed to be the origin of the non-PV trigger. D: PEN was moved more anterior, including the previous earliest yellow tag to confirm the accuracy of the map. The earliest activation site was PEN 9-10, which was the same as the previous earliest activation site. ABL = ablation catheter; CS = coronary sinus; d = distal; p = proximal; PEN = PentaRay; PV = pulmonary vein; RA = right atrium; SVC = superior vena cava. HeartRhythm Case Reports 2018 4, 26-28DOI: ( /j.hrcr ) Copyright © 2017 Heart Rhythm Society Terms and Conditions

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