Figure legends
Figure 1: A: Intra-cardiac electrocardiogram mapping of the right atrium, right ventricle and functional tricuspid annulus. All mapping is done during inspiration and diastole. The purple tag represents funcitonal annulus. B-1: Endocardial electrocardiogram during successful ablation. The atrial and ventricular activity were fused at ABL1-2, and the atrial activity disappeared after ablation. B-2: 3D view of funcitonal annulus and ablation success point. The red tag was the ablation tag, the * is the success point. The functional annulus and the ablation success point were far apart.
ARA: arterized right atrium, RV: right ventricle, FA: functional tricuspid annulus, LAO: left anterior oblique, RAO: right anterior oblique
Figure 2: A: 12-lead electrocardiogram during rapid wide QRS response via accessory pathway during AF. Atrial waves were recorded at 9-10 of the Penta ray, indicating that the valve leaflets were being mapped. Narrow QRS conducts through the AV node, and wide QRS conducts through the accessory pathway. B: Maximum pre-excitation pattern matching data. The pattern of waveform acquisition was from pre-excitation to the end of the QRS in the wide QRS waveform via accessory pathway during atrial fibrillation. C: :Mapping of ventricular activity with maximum pre-excitation. Narrow QRS 1 was conduction through the AV node. No potential was acquired under waveform 1 by pattern matching. Wide QRS 2, a potentials was not acquired because pattern matching score is unde the correlation threshold. Wide QRS 3 was acquied a potential because pattern was matched. To acquire potentials from the preexitation of the wide QRS to the end of the QRS, waveforms in the range shown in the figure were acquired.
Figure 3: A is propagation map using LAT resulted in a disordered map and B is Ripple map (RM). A, B and C, in that order, are still images of 10msec each. They are in chronological order from 1 to 3. The map A can be seen that the propagation does not identify the acesory pathway. The map B was used to identify the accessory pathway during AF. The ripple map bars show the tricuspid annulus passing through the accesory pathway as the earliest in the timeline. The red and pink tags are ablation tag. See supplement movie 1.