Does Mapping Catheter Geometry and Location Affect AF Driver Detection? A Simulation Study

In atrial fibrillation the correct identification of both presence and location of rotors during the ablation procedure could support the physician to optimize therapy administration. In this study we developed a tool that allows testing the capability of mapping catheters of detecting AF drivers with different shapes and in different acquisition conditions. Wave propagation was obtained using a monodomain implementation and a modified Courtemanche model. Two commercial catheters were simulated (Advisor™ HD Grid and PentaRay®). Our framework allowed the acquisition of the signal in unipolar mode at and to assess the effect of the influence of catheter inter-electrode spacing, coverage and endocardium-LA wall distance for rotor detection. In contact with the wall and within 1 mm distance from the real core all the configurations allowed a correct detection of the rotor, irrespective of geometry, coverage and inter-electrode distance. Increasing the interelectrode distance causes the incapability of rotor detection at a closer distance from the LA wall in the HD grid. The tool was effective in assessing how catheter geometry and specific parameters affect its capability to detect rotors. In the future, other catheter morphologies and different design parameters and acquisition conditions will be investigated.