New technologies in electroanatomic mapping for a better mechanism characterization of supraventricular tachyarrhythmias

Background Provide a brief overview of recent technological advances that can potentially give information for treatment of different kind of arrhythmias. Methods In this report, we describe the features of Omnipolar technology (OT) using high density mapping catheter and we report five different scenario in which this new tool can give some important information to understand arrhythmia’s substrate and guide the treatment. OT combine three unipolar and two bipolar signals and provides maximum voltage regardless of electrode-wavefront orientation, local wavefront activation direction and local measurements of wave speed: it allow to create a velocity map. Results OT has been used to study different types of supraventricular tachycardias. Regarding reentry tachycardias, velocity map has allowed the characterization and definition of the impulse velocity along the dual nodal pathway and the accessory pathways (AP). As regards atrial flutter, it has successfully allowed the definition of the slowest zone of the critical isthmus and radiofrequency (RF) delivery at that point resulted in termination of the arrhythmia. During mapping of the left atrium in sinus rhythm, the velocity map allowed the identification of the course of the Bachmann’s bundle, which could potentially play a role during the ablation of persistent atrial fibrillation (AF). Conclusion OT and velocity map offer significant advantages in the management of challenging arrhythmias, and can potentially improve the efficacy of the treatment of some arrhythmias such as atrial flutter and AF.