Using Global Atrial Patterns to Interpret Atrial Tachycardia
Maps
In this issue of the Journal , Kuroda et al. [Kuroda JCE 2021 –
Editor please insert] systematically evaluated the novel
“CoherentTM” algorithm that uses global patterns of
propagation to resolve ambiguities in electrogram marking and create a
“best-fit” map during stable arrhythmias. In N=77 patients with
scar-related AT, the team retrospectively compared this novel algorithm
with standard activation mapping, referenced to the gold standard of
full clinical assessment (entrainment and acute ablation outcome). The
novel algorithm more accurately determined AT location and mechanism
(macro-reentry, localized reentry and focal tachycardia) in single
(67.2% vs 44.8%, P=0.009) and dual-loop circuits than standard
mapping, accurately reclassified mechanisms in cases when standard
mapping failed, and reduced inter-observer variability.