An advanced algorithm for the online detection of abnormal and late potentials during sinus rhythm in the setting of ventricular tachycardia ablation

We describe the case of a 40-yearold man with ischaemic cardiomyopathy and severe left ventricular dilatation, presented at our institution for recurrent, drug refractory, and ventricular tachycardia (VT). The left ventricle (LV) was approached anterogradely via transseptal puncture allowing the reconstruction of 2D, high density map, using a multielectrode basket catheter (Orion)—Rhyhtmia suite (Boston Scientific, Marborough, MA, USA). The LV geometry was first acquired during sinus rhythm; bipolar voltage map documented an area of scar along the LV lateral wall extending from basal to apical segments (Figure 1, Bottom Panel A). The newest software algorithm ‘LUMIPOINT’ allows a quick and online analysis of local abnormal activities and of late potentials (LPs). In our case, the highlighted zone (Figure 1, Bottom Panel B) follow to the selection of a specific timeframe where the search of LP is performed (þ5 ms from QRS offset to þ45 ms) (green bar). The LP area so far delimited exactly corresponded to the entrance and isthmus circuit of the clinical VT (CL 430 ms) induced later (Figure 1, top panel). Pulses of radiofrequency (50 W) were delivered at the isthmus site and caused the termination of the arrhythmia within 5 s. This clinical case supports the findings reported by another group: the use of this novel