PO-04-134 STAR MAPPING METHOD TO IDENTIFY ENDO-EPICARDIAL DISSOCIATION AND DRIVING SITES IN PERSISTENT ATRIAL FIBRILLATION

Recurrence rates following ablation for persistent AF (psAF) remain high with the underlying mechanisms complex and poorly understood. Asynchronous activation of endocardial epicardial surfaces during AF, defined as endo-epicardial dissociation (EED) may be a driver AF. We aim to investigate whether using novel vector mapping approach, Stochastic Trajectory Analysis Ranked (STAR) signals, endo- early sites (ESA) can identified. Six (6) patients underwent utilizing pericardial percutaneous CO2 insufflation technique. Two AdvisorTM HD Grid catheters were placed in corresponding positions left atrium. During 30 second segments recorded at base atrial appendage, anterior, inferior, lateral posterior LA wall. Fifteen (15) analysed STAR maps assessed ESA variation direction wavefront between endocardium epicardium. Activation was dissociated if there >40-degree difference simultaneous wavefronts on mapping. For each recording more than 1 dominant direction, 2 most common used an average taken. The overall mean angulation epicardium 71 ± 55 degrees. Nine (9) 15 (53%) showed >40 degrees activation. Of these 9, 3 wall, wall anterior identified 6 mapped endo 4 (67%) ESAs identifies discrepancy showing EED multiple atrium majority surface.