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• W4377014462 abstract "Discrimination between near-field (NF) vs. far-field (FF) components in electrograms (EGMs) is mostly based upon intuitive perception of local EGM sharpness. As high-density mapping catheter use has expanded, the difficulty of discerning sub-components across many EGMs in realtime has increased. To date no mapping system had employed a means to quantify this distinction. A novel detection algorithm was designed to identify sharpness of NF EGM components by annotating the highest Peak Frequency (PF) of a signal. To provide insight into first clinical use cases of NF annotation algorithm and PF data. Acute procedure data were prospectively collected from 32 operators at 16 institutions in the US and Europe. All cases were performed on EnSite X system with EnSite OT Near Field software (Abbott). PF information was used as an adjunct to activation or voltage maps via an emphasis layer or as a standalone map (Figure). Choice of mapping tools and technique was at physician discretion. Analysis included ablation cases (n=175) with the following indications: AF (60.6% [54.7% PAF, 45.3%, PsAF; 34.9% redo]), SVT (20.6%), and VT/PVC (18.9%). The NF algorithm was the roving detection option of choice for automated point collection in most cases (96.2% of AF cases, 91.7% SVT, 69.7% VT/PVC). Alternative detections were Last Deflection in VT cases (33%) and First Deflection in PVC cases (29%). When NF was used, correctness of EGM annotation was noted as highly accurate in 93.5% of cases. Standalone PF maps were used as a diagnostic tool in 48 (27.4%) Depth of Activation Insights cases. Bounding values for map display were variable based on use-case to highlight various electrophysiologic phenomena (Table). In an AF use case, PF was used for gap identification (n=6); values were applied at 225±28 Hz, consistent with previously published value of 240Hz (Merino, et al. EHRA 2022). Alternatively in VT/PVC cases, low PF far-field zones were highlighted to assess activation at depth in tissue; mean values were 198±10 Hz. Peak frequency mapping helps distinguish near field from far-field electrograms. PF mapping can be used as (1) a standalone mapping technique to accurately identify near field components and (2) PF mapping can be used as an adjunctive technique to complement activation and voltage maps. PF mapping appears to assist in substrate differentiation, pathway localization, and contact assessment. Further research is warranted on optimal settings for various tissue types and rhythms.Tabled 1Table. Standalone PF mapsValues in HzValues in HzUsed InUsed InUsed InIntention of Map UseColor Range HighColor Range LownAFSVTVT/PVCCritical Isthmus Identification424 +/- 70222 +/- 445YesYesYesDepth of Activation Insights490 +/- 300198 +/- 3010YesYesFF LAA vs NF PV EGM475 +/- 268220 +/- 256YesPV Gap Identification400 +/- 257225 +/- 286YesSlow Pathway Modification231 +/- 4345 +/- 7911YesOther**10YesYesYes Open table in a new tab" @default.
• W4377014462 created "2023-05-19" @default.
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• W4377014462 date "2023-05-01" @default.
• W4377014462 modified "2023-09-27" @default.
• W4377014462 title "PO-03-101 PEAK FREQUENCY INITIAL US AND EUROPEAN EXPERIENCE: A NOVEL MEASURE TO DISTINGUISH NEAR-FIELD FROM FAR-FIELD EGM COMPONENTS" @default.
• W4377014462 doi "https://doi.org/10.1016/j.hrthm.2023.03.1014" @default.
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