Abstract
Although a high-resolution three-dimensional mapping system has made it
possible to treat complicated atrial tachyarrhythmia (AT), there remain
cases that are difficult to diagnose and treat. 1,2
When a single atrial tachycardia is present and stable, mapping is
relatively easy. However, when multiple different ATs alternately
appear, mapping and diagnosis of those are more difficult. Parallel
mapping module is well known as a good option to simultaneously map two
or more different ATs when they alternately appear. 3
When performing parallel mapping of two different ATs, one bipolar
signal of the reference catheter is used as a timing reference and a
cycle length filter is used for differentiating AT1, AT2, and others,
including sinus rhythm, fusion beats, or catheter-induced premature
atrial complex. Therefore, it has some limitations for differentiating
multifocal ATs. We present a case wherein multifocal ATs were
successfully eliminated by combining parallel mapping module and
dual-chamber intra-cardiac pattern matching technique that we have
previously reported. 4