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We report the use of the new automated tool Lumipoint TM for the detection of LAVA (local abnormal ventricular activities) when they are buried within the far-field ventricular signal, especially in regions of preserved myocardial thickness, such as the left ventricular (LV) septum. The LV substrate and the tachycardia circuit during ventricular tachycardias of a 60-year-old man with dilated cardiomyopathy were mapped using an ultra-high-density mapping system and then the Lumipoint TM , analyzing the EGMs of interest, identified the LAVA in the inferoseptal region. This algorithm may be helpful to quickly target the septal substrate avoiding misleading interpretation., Competing Interests: No external funding was obtained for this project. Francesco Maddaluno and Maurizio Malacrida are Boston Scientific employees, no other conflicts of interest exist., (© 2020 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society.)

The new Lumipoint™ algorithm based on map analysis with several features is a valuable aid to understanding complex circuits, particularly as it can unmask areas with dissociated activity misleadingly annotated by an automatic mapping system., Competing Interests: No external funding was obtained for this project. Francesco Maddaluno and Maurizio Malacrida are Boston Scientific employees, no other conflicts of interest exist., (© 2019 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Patients with third-degree atrioventricular block implanted with a dual-chamber pacemaker in DDD mode can develop pacemaker-mediated tachycardias if retrograde ventriculoatrial (VA) conduction is present. Programming a long post-VA refractory period to avoid tachycardia initiation can be contraindicated if these patients have a good atrial response from exercise testing and require a high maximum tracking rate to allow for a proper response to sensed atrial rhythms. We report a case of a patient in whom mapping and ablation of retrograde conduction during the pacemaker-mediated rhythm was the only solution to allow both the programming of a high tracking rate and the elimination of tachycardia induction., Competing Interests: Dr. Ducceschi is a consultant for Boston Scientific. Mr. Maddaluno is a Boston Scientific employee. The other authors report no conflicts of interest for the published content., (Copyright: © 2019 Innovations in Cardiac Rhythm Management.)

The Rhythmia ultrahigh-density mapping system with a specific algorithm seems to be helpful in identifying the target area to successfully treat multiple morphologies by catheter ablation in the right ventricular outflow tract RVOT. Interestingly, the acquisition process seemed to be extremely faster than a standard manual point-by-point premature ventricular contraction (PVC) mapping.