Arrhythmias & electrophysiology

Tau20-RETROmapping System Identifies Driver-Like Activation Patterns in Real Time During Persistent Atrial Fibrillation

Circ Arrhythm ElectrophysiolPublished Validation study of an investigational mapping system

Authors' conclusion

The Tau20-RETROmapping system enables real-time activation mapping of AF, with the most convincing driver-like areas being identified around the LAA.

Study context

Population
Patients undergoing pulmonary vein isolation for atrial fibrillation (AF)patients undergoing pulmonary vein isolation for AF · sinus rhythm or atrial tachycardia (AT) Six · mapped in AF Eighteen
Participants
24 patients
Comparison
Tau20-RETROmapping system against manual validation of randomly sampled local electrograms
Outcome
Diagnostic accuracy in sinus rhythm or AT

Performance

As reported in the abstract

Sensitivity

100.0%

95% CI 80.5%–100.0%

Specificity

100.0%

85.2%–100.0%

Further findings

Identifying organized AF wavefronts

Sensitivity
94.4% (86.2%-98.4%)
Specificity
97.1% (89.9%-99.6%)
Accurately identified the earliest activation, of waves
89.6% (79.7%-95.7%)

Propagation patterns relative to the left atrial appendage (LAA) during AF

Stable propagation originating from the LAA
3/18 patients
Competing propagation toward and away from the LAA
8/18
Conduction away from the LAA along the anterior wall
8/18 patients
Conduction away from the LAA along the lateral wall
8/18 patients
Conduction away from the LAA along the posterior wall
7/18 patients
No propagation near the LAA
6/18 patients

Original publication

Tau20-RETROmapping System Identifies Driver-Like Activation Patterns in Real Time During Persistent Atrial Fibrillation. Circ Arrhythm Electrophysiol. Published 2 July 2026. doi:10.1161/circep.126.015039

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