B-PO05-081 SIMULTANEOUS ULTRA-HIGH RESOLUTION OPTICAL MAPPING AND CATHETER MAPPING IN A LANGENDORFF-PERFUSED SWINE HEART MODEL TO IDENTIFY ATRIAL FIBRILLATION ROTORS BY CATHETER MAPPING

Abstract

The accuracy of atrial fibrillation (AF) rotor identification by catheter mapping (CM) has not been validated. To obtain simultaneous ultra-high resolution optical mapping (OM) and high resolution CM during AF in a Langendorff perfused swine heart model to test the feasibility of identifying AF rotors by CM. Langendorff preparation was performed in 3 swine. The isolated heart was stained with a voltage-sensitive dye, illuminated by LED. Two high resolution CCD cameras (26,624 pixels, each) simultaneously recorded fluorescence from the RA and LA free-wall (spatial resolution <0.1mm). Two mapping catheters (48 electrodes, 2 mm spacing, and one central non-contact reference electrode for close unipolar EGMs, OCTARAY, Biosense Webster, Fig) was sutured on the RA and LA, covering 3x3 cm area, respectively (total 96 close unipolar EGMs). An anatomical shell of RA and LA was formed using the CARTO3 system. AF was induced by rapid atrial pacing during atrial stretch. Optical signals (membrane potential map and phase map) and catheter epicardial atrial EGMs (AF activation map) were recorded simultaneously during AF. (Fig.) During AF, OM identified stable and/or unstable rotors in all 14 AF episodes (all 3 swine), often located at the base of RA or LA appendage. Compared to unstable rotors, stable rotors had shorter cycle length (median 105 ms vs 114 ms, p<0.05). CM identified corresponding rotational activities (spiral reentry) when the rotor was located close to the center of the electrodes. There was no false positive rotor detection by CM. Close unipolar CM identifies AF rotors, but only when rotor centers are located within the mapping area.