Uday Sandhu Brock Gambill Mason McNeil Propagation and point density

Uday Sandhu Brock Gambill Mason McNeil Our approach: "Term"=first site: AFL slowed/terminated late in lesion. Extended into SVC to cover "upper isthmus" and snuck down into "lower isthmus" (pacing before each burn). Did not go to IVC as ?prior scar/block. Final CS pace map suggest fixed block. Noninducible after.

Grid at channel. >100ms of continuous, fractionated signals spanning diastole.

Atypical AFL Post Surgical Maze - Hx LAA ligation, MV repair, CTI, & line from LSPV to appendage. 3D Entrainment confirmed passive activation of PW. Mapped with #HDGrid Arek Karagoezian

6 y.o. pt with pathway mediated SVT. Diagnosed as PJRT during EPS due to long RP, decremental props, and retrograde cond through path. Upon induction, 2 tachs alternated with slightly different p-wave and CS morphs. TactiCath SE used for successful RF abl of both pathways! #EPeds

Redo AFib. An AAFL was induced with extra stimulus pacing, but unstable and difficult to map. Our CS pace ILAM map done with #HDGrid led us to a clear ablation target. Check out that isochronal crowding! #EPeeps Abbott Cardiovascular

Antero-lateral papillary (ALP) PVC mapped on #EnsiteX’s magnetic primary (Voxel) mode. ICE and #HDGrid was used to map and locate the target 🎯. Earliest point was -52 early on the medial side of the ALP. @JohnSummers_MD

Ablation of #Mahaim AP. 6yo Pt. Brought in for successful treatment of WPW, after which a Mahaim AP was diagnosed, assessed, located, and successfully ablated with #TacticathSE on the first burn. #EPeds Brandon Mukai

WPW mapped with #HDGrid allowed us to see fusion in two distinct areas to determine an early bifurcation of the pathway. Pre-excitation eliminated using #TactiCathSE

Satisfying termination of focal atrial tachycardia, preceding p-wave by 41 ms #HDGrid

Atriotomy scar AFL on a patient w/ prior CTI line. CS activation was stacked, and initial LA map appeared focal from near anterior RSPV os. Cryo PVI for parox AF + focal RF in the earliest LA spot had no effect on tach. Subsequent RA map added a missing part to the story. #EPeeps

Termination of incessant AT, localized to non-coronary cusp corresponding to multiphasic #ECG morphology. Jaylynn Markey Conley Stumpfl

The anterior right pulmonary vein antrum, an under appreciated topography? Atrial diverticulum seen here, perhaps culprit of temperature & impedance limiting during Radiofrequency #Ablation. Imaged during unrelated, Focal Atrial #Tachycardia #Ultrasound #EPeeps credit Ashit Patel

Entrainment with Orthodromic Upstream Capture, 85% of TCL at suspected posterior wall circuit. #HDGrid fragmented electrograms created challenge in accurately identifying consistent PPI’s. NNE (Number Needed to Entrain) color map created in leu, right image. D Randy Jones

Focal Atrial Tachycardia localized to Crista Terminalis triggering Orthodromic Reciprocating Tach mapped to Inferoseptal Mitral Annulus. #EnSite Continuous Score Map correlated well to AT P-Wave morphology. #PDXMapping by Marissa Martinez Paige Reisman - EP Ashit Patel

Over 500ms of fractionated EGMs across #HDGrid, capturing entirety of TCL during this left atrial flutter. Hx cryo PVI. credit Sandeep Saha, MD MS FACC FHRS