Assessment of an ECG‐Based System for Localizing Ventricular Arrhythmias in Patients With Structural Heart Disease
| Autor: | Shijie Zhou, Harikrishna Tandri, Amir AbdelWahab, Ronald D. Berger, Jonathan Chrispin, B. Milan Horacek, Natalia A. Trayanova, Konstantinos N. Aronis, Eric Sung, James W. Warren, Paul J. MacInnis, John L. Sapp, Rushil Shah |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Heart disease Translational Studies Arrhythmias Electrocardiography ventricular tachycardia (VT) Internal medicine Clinical Studies Medicine Humans In patient Arrhythmia and Electrophysiology Prospective Studies Pace mapping Original Research Retrospective Studies business.industry ECG premature ventricular contraction (PVC) Reproducibility of Results pace‐mapping medicine.disease Ventricular Premature Complexes Electrophysiology Cardiology Catheter Ablation Tachycardia Ventricular radiofrequency (RF) ablation structural heart disease (SHD) Cardiology and Cardiovascular Medicine business Catheter Ablation and Implantable Cardioverter-Defibrillator |
| Zdroj: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| ISSN: | 2047-9980 |
| Popis: | Background We have previously developed an intraprocedural automatic arrhythmia‐origin localization (AAOL) system to identify idiopathic ventricular arrhythmia origins in real time using a 3‐lead ECG. The objective was to assess the localization accuracy of ventricular tachycardia (VT) exit and premature ventricular contraction (PVC) origin sites in patients with structural heart disease using the AAOL system. Methods and Results In retrospective and prospective case series studies, a total of 42 patients who underwent VT/PVC ablation in the setting of structural heart disease were recruited at 2 different centers. The AAOL system combines 120‐ms QRS integrals of 3 leads (III, V2, V6) with pace mapping to predict VT exit/PVC origin site and projects that site onto the patient‐specific electroanatomic mapping surface. VT exit/PVC origin sites were clinically identified by activation mapping and/or pace mapping. The localization error of the VT exit/PVC origin site was assessed by the distance between the clinically identified site and the estimated site. In the retrospective study of 19 patients with structural heart disease, the AAOL system achieved a mean localization accuracy of 6.5±2.6 mm for 25 induced VTs. In the prospective study with 23 patients, mean localization accuracy was 5.9±2.6 mm for 26 VT exit and PVC origin sites. There was no difference in mean localization error in epicardial sites compared with endocardial sites using the AAOL system (6.0 versus 5.8 mm, P =0.895). Conclusions The AAOL system achieved accurate localization of VT exit/PVC origin sites in patients with structural heart disease; its performance is superior to current systems, and thus, it promises to have potential clinical utility. |
| Databáze: | OpenAIRE |
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