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.