Development of a Rotor-Mapping Algorithm to Locate Ablation Targets During Atrial Fibrillation

Abstract

Catheter ablation therapy involving isolation of pulmonary veins (PVs) remains the cornerstone procedure to treat AF. However, due to the sub-optimal success rates of PV isolation, there is a need for new ablation techniques to locate AF ablation targets known as rotors, outside of the PVs. In this paper, we developed a novel rotor-mapping algorithm that uses a conventional diagnostic catheter, Lasso, to locate a rotor source. The algorithm, called the Region of Rotor (ROR) Mapping, utilizes the characteristics of local bipolar electrograms to navigate the catheter's iterative placements while generating a map, overlaid on the atrial anatomy, that displays the potential rotor region. We evaluated the developed ROR mapping algorithm using a 2D simulation of AF on a tissue with heterogeneous conduction properties. The results demonstrated a significant success rate of 93% in accurately locating the region of the rotor with a mean distance of 1.4mm from the ground truth trajectory. The algorithm could play a critical role in mapping non-PV AF ablation targets and improving the outcome of AF ablation.