Noninvasive Classification of Ventricular Preexcitation with Unshielded Magnetocardiography and Transesophageal Atrial Pacing and Follow-Up

Autor:	Donatella Brisinda, Riccardo Fenici
Rok vydání:	2007
Předmět:	trans-esophageal pacing Heart Ventricles medicine.medical_treatment Sensitivity and Specificity WPW Electrocardiography Esophagus Text mining Humans Medicine Sinus rhythm ventricular preexcitation Magnetocardiography Atrial pacing business.industry Cardiac Pacing Artificial Arrhythmias Cardiac General Medicine Gold standard (test) Ablation WPW SYNDROME Accessory pathways Transesophagea atrial pacing Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE Ventricular preexcitation Wolff-Parkinson-White Syndrome Cardiology and Cardiovascular Medicine business Nuclear medicine Algorithms
Zdroj:	Pacing and Clinical Electrophysiology. 30
ISSN:	1540-8159 0147-8389
DOI:	10.1111/j.1540-8159.2007.00627.x
Popis:	Background: Ventricular preexcitation (VPx) is usually localized noninvasively by means of electrocardiogram (ECG) algorithms, which vary in their concordance levels. Contactless magnetocardiography (MCG) has been used as an alternate 3-dimensional (3D) method of accessory pathways (AP) localization. The sensitivity of MCG can be increased for preoperative evaluations and planning of ablation procedures by combining it with transesophageal pacing (TEP) and electrophysiological (EP) studies. This study compared the accuracy of VPx localization with MCG with ECG algorithms, and examined the increment in diagnostic accuracy achievable with TEP. Methods: Multisite mapping from the anterior chest wall was performed with a 36-channel MCG system. TEP allowed the evaluation of anterograde conduction properties and inducibility of arrhythmias. The reproducibility of the test and follow-up was examined in 88 patients with Wolff–Parkinson–White (WPW) syndrome. The accuracy of MCG localization was reevaluated during pacing-induced maximal VPx in 36 patients in whom, during MCG, the degree of VPx was highest during TEP. The gold standard for validation was effective ablation of the AP. Results: The MCG classification of VPx was accurate in 94% of AP, versus 64% and 67% with ECG, during sinus rhythm and during pacing-induced maximal VPx, respectively. In 4.5% of cases with unclear ECG localization, MCG suggested a complex septal VPx. In all patients with successful ablations, the 3D MCG localization of the AP corresponded to the ablation site. Conclusions: MCG was more accurate than ECG for the classification of VPx and provided additional information in the non-invasive EP assessment of patients with WPW syndrome.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5f8cebd15e0528ad2cfe9c896fa0a09a https://doi.org/10.1111/j.1540-8159.2007.00627.x Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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