Electroanatomic mapping of atrial tachycardia—Manual vs automated annotation☆

Introduction The availability of novel mapping systems and software in combination with or without dedicated multipolar diagnostic catheters allows for automatic high-density 3-dimensional electroanatomic mapping that enables detailed insight into atrial tachycardia mechanisms. For the accuracy of the activation map, the consistency of electrogram annotation is crucial. Depending on the system used, numerous algorithms (eg, peak amplitude or rapid downstroke of the unipolar signal) are currently implemented that can be selected for automatic signal annotation. For reliable automatic high-density mapping with thousands of points acquired within a few minutes, the robustness of the implemented algorithm is critical, especially for fractionated signals or double potentials.