Mapping Comp VS#2

Difference between roving and acquisition waveforms

*Roving = continuously moving with the signal

*Acquisition = updating beat by beat based on setting a reference detection

What part of our waveforms are analyzed for REF and ROV detection?

1. For REF detection, we look continuously at our ECG/EGM signals and pick the signals that match our algorithm with each beat.

2. For ROV detection, we are specifically looking at signals within our window

What detection algorithms are available for…

1) Reference detection?

2) Roving detection?

1) Max, min, abs peak, +dV/dt, -dV/dt, abs dV/dt, first deflection

2) All of the above plus last deflection and near field

If I increase my sensitivity setting, I will become ______ sensitive.

Less (i.e. look at only bigger signals)

For what detection (REF and/or ROV) and what algorithms is sensitivity adjustment possible? 

ALL reference algorithms + LAST and FIRST deflection for Rov algorithms

How is OT Near Field as a ROV detection algorithm used? Next best option if NF is not used?

It annotates the signal of sharpest frequency, regardless of whether it has the highest amplitude. This suggests that it is a near field signal.

Next best option to use would maybe be abs dV/dt

What kind of ROV detection algorithm may be most appropriate for…

1. SLAM/ILAM/VT mapping?

2. Focal rhythm mapping?

1. Last deflection or NF

2. First deflection

Default reference and roving detections?

Default REF: (ECG 1) Max

Default ROV: abs Peak, or NF if OTNF is installed

1. Requirements to have secondary reference

2. Purpose of secondary reference

1. Must have REF 1 selected as intracardiac signal + cardiac triggered map type is selected. REF 2 is also an intracardiac reference

2. Activation sequence threshold can be established to measure timing difference between Ref 1 and Ref 2 (i.e., Activation Sequence). Used with AutoMap as a discriminator and depends on what AST we select to determine if points are saved or not.

*Need REF 2 to be set up by the time I save my first point

How is cycle length measured on my screen?

From my present reference detection annotation to the previous one

What happens when “No Location” appears above my signals?

Catheter may be out of high confidence or in the sheath, no points collected

Cardiac Triggered Reference vs Non-Cardiac Triggered Reference and what map types are available INITIALLY/DEFAULT

CRT: dependent on a timing reference, be it ECG or EGM. Tells the system that I am creating a timing map → initially LAT map

NCRT: Does not require a timing reference. Can adjust time and refractory period. Set a fixed time and refractory period. Default time is 1 second, can set up to 4 seconds. Best for measuring complex fractionated signals → map types CFE Mean, CFE STDEV, Fractionation

4 types of LAT maps - list

Standard, Re-entrant, Propagation, Full-color propagation

LAT Standard Maps:

1. How is timing being evaluated?

2. What are the rules for colors?

3. Can I move the color slider?

4. What does Auto Color do?

1. As the difference in ms between the zero offset line and the ROV detection

2. White and purple CANNOT touch so will interpolate color spectrum between them.

3. Yes!

4. Automatically sets white to earliest signal and purple to latest, with isochrones evenly divided in between. Isochrones apply even if auto color is off.

*Rhythms: Think focal - PAC, AT, PVC

LAT Re-entrant Maps:

1. How is timing being evaluated?

2. What are the rules for colors?

3. Can I move the color slider?

1. Time difference in ms between zero offset and roving detection (not as important here, subject to vary)

2. Colors span the entire mapping window I set (or CL). White and purple SHOULD touch. Non-ordered colors that touch = lines of block

3. Only as a whole entity

*Should have all colors displayed if we are in the correct chamber mapping the re-entrant circuit

True or False: White can be removed from the color spectrum for all LAT maps

True

Propagation versus sparkle map: main difference?

Propagation maps are tied to interpolated data (i.e. points can be interpolated to represent larger or smaller areas), whereas sparkle maps are NOT.

What is a (full color) propagation map? Can I manually adjust the wavefront if the propagation is paused?

Dynamic display of the propagation of a wavefront based on activation time. Yes you can!

How does a sparkle map work?

Allows viewing of the activation sequence on top of a base map. Every point collected will sparkle

What is a peak-to-peak map?

Measures negative to positive peaks of voltage signal and indicates overall voltage measurement (mV), colors ranging from gray to purple

When might a Peak Negative map be used?

For complex VT or seeing deeper substrate

For a Peak Frequency Map based on peak frequencies of each EGM, what do the colors tell us?

White = high frequency, NF

Dark/Gray = low frequency, FF

Fractionation Map:

1. What does it measure?

2. What does “width” mean?

3. What does “refractory” mean?

1. Indicates the number of complex fractionated EGM detections, or “turns,” for a given signal

2. Width = minimum complex width to consider for activation

3. Refractory = minimum amount of time between detections of signals

CFE Mean vs CFE STDEV

CFE Mean = fractionation index is based on mean cycle length between multiple local activations

CFE STDEV = fractionation index is based on STDEV of cycle length between multiple local activations

*White = low value, purple = high value

When might a base map with peak frequency be used?

To identify regions of low voltage and high frequency, i.e. critical isthmus

4 possible emphasis maps

LAT, voltage, peak frequency, wave speed

How does a score map work?

Displays colors based on score values or collected morphology. Used for PACs/PVCs. White = low match, purple = high match

What is a point count map

The brother of a projection map. Essentially more saturated regions = more points co-collected, less saturated = less points co-collected in that region.

Automated Outlier Filtering

RESUME HERE!