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Review
. 2018 Dec;7(4):261-264.
doi: 10.15420/aer.2018.44.3.

Arrhythmia Mechanisms Revealed by Ripple Mapping

George Katritsis  1 , Vishal Luther  1 , Prapa Kanagaratnam  1 , Nick Wf Linton  2
Affiliations
Review

Arrhythmia Mechanisms Revealed by Ripple Mapping

George Katritsis et al. Arrhythm Electrophysiol Rev. 2018 Dec.

Abstract

Ripple mapping is a novel method of 3D intracardiac electrogram visualisation that allows activation of the myocardium to be tracked visually without prior assignment of local activation times and without interpolation into unmapped regions. It assists in the identification of tachycardia mechanism and optimal ablation site, without the need for an experienced computer-operating assistant. This expert opinion presents evidence demonstrating the benefit of Ripple Mapping, compared with traditional electroanatomic mapping techniques, for the diagnosis and management of atrial and ventricular tachyarrhythmias during electrophysiological procedures.

Keywords: Atrial tachycardia; catheter ablation; electroanatomic mapping; ripple mapping; ventricular tachycardia.

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Conflict of interest statement

Disclosure: George Katritsis has no conflicts of interest to declare. Imperial Innovations holds intellectual property relating to Ripple Mapping on behalf of Prapa Kanagaratnam and Nick Linton, who have also received royalties from Biosense Webster, Inc. Vishal Luther, Prapa Kanagaratnam and Nick Linton have received consulting fees with respect to Ripple Mapping from Biosense Webster, Inc.

Figures

Figure 1:
Figure 1:. Electrogram Representation During a Ripple Map
Figure 2:
Figure 2:. Ripple Map of Counterclockwise Typical Right Atrial Flutter
Figure 3:
Figure 3:. Activation Map, Bipolar Voltage Map and Ripple Map of a Post-AF Ablation Atrial Tachycardia
Figure 4:
Figure 4:. Ventricular Tachycardia Substrate Identified By Ripple Mapping During Pacing
Figure 5:
Figure 5:. Ripple Map of Scar-Related Ventricular Tachycardia
See this image and copyright information in PMC

References

    1. Ben-Haim SA, Osadchy D, Schuster I et al. Nonfluoroscopic, in vivo navigation and mapping technology. Nat Med. 1996;2:1393–5. doi: 10.1038/nm1296-1393. - DOI - PubMed
    1. Del Carpio Munoz F, Buescher TL, Asirvatham SJ. Three-dimensional mapping of cardiac arrhythmias: what do the colors really mean? Circ Arrhythm Electrophysiol. 2010;3:e6–11. doi: 10.1161/CIRCEP.110.960161. - DOI - PubMed
    1. Earley MJ, Showkathali R, Alzetani M et al. Radiofrequency ablation of arrhythmias guided by non-fluoroscopic catheter location: a prospective randomized trial. Eur Heart J. 2006;27:1223–9. doi: 10.1093/eurheartj/ehi834. - DOI - PubMed
    1. Josephson ME, Anter E. Substrate mapping for ventricular tachycardia: assumptions and misconceptions. JACC Clin Electrophysiol. 2015;1:341–52. doi: 10.1016/j.jacep.2015.09.001. - DOI - PubMed
    1. Cassidy DM, Vassallo JA, Miller JM et al. Endocardial catheter mapping in patients in sinus rhythm: relationship to underlying heart disease and ventricular arrhythmias. Circulation. 1986;73:645–52. doi: 10.1161/01.CIR.73.4.645. - DOI - PubMed