B-po02-138 mapping of repetitive atrial rhythms using multi-position non-contact charge density mapping: insights from the discover european registry evaluating real-world use of the acqmap system

AcQMap (Acutus Medical, Carlsbad, CA) provides a novel approach (SuperMap) for mapping regular atrial rhythms (RAR). Data from the DISCOVER registry to evaluate the use of SuperMap (SM) in patients scheduled for de novo or re-treatment of atrial fibrillation (AF). Analyze the subset of patients in the DISCOVER registry in which SM was used to map RAR and/or assess substrate during the procedure. SM categorizes signal morphology and time aligns electrograms acquired by roving the mapping catheter to multiple positions within the atrium during RAR. (Fig). Fifty-six (56) of 125 patients enrolled in the registry had RARs mapped. Patients were 66% male, 61.0 ± 10.8 y o, AF duration of 3.3 ± 3.8 y. Fifty-four percent (54%) were retreatments and 54% had non-PV targets mapped and ablated during their procedure. A total of 104 SM recordings produced 134 maps. Mean time to acquire map data was 2 min 45 sec ± 1 min 24 sec. SM was used to assess substrate (block, sinus and paced rhythms) 35.8%, Focal 29.9%, Macro-reentry 23.1%, Micro-reentry 8.2%, Mechanism undetermined 2.2% and Other 0.7%. (Fig) Mean time to SM and rhythm diagnosis/substrate characterization/start of ablation was 13 min 54 sec ± 11 min 6 sec. Forty-three percent (43%) of maps resulted in therapy delivery, 48% were used to confirm block or RAR spontaneously converted or DCCV, 9% were missing data. All patients were in sinus rhythm (SR) at the end of the procedure and 34 of 36 patients (94.4%) with 6-month data recording remained in SR. In patients included in the DISCOVER registry, SM has been used efficiently to map and diagnose RAR during de novo and re-treatment AF procedures.