Prospective Multicenter Assessment of a New Intraprocedural Automated System for Localizing Idiopathic Ventricular Arrhythmia Origins
| Autor: | James W. Warren, Konstantinos N. Aronis, Shijie Zhou, Ronald D. Berger, Natalia A. Trayanova, Amir AbdelWahab, Paul J. MacInnis, Harikrishna Tandri, Rushil Shah, John L. Sapp, Eric Sung, Jonathan Chrispin, B. Milan Horacek |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Electroanatomic mapping
medicine.medical_specialty medicine.medical_treatment Catheter ablation 030204 cardiovascular system & hematology Article 03 medical and health sciences QRS complex Electrocardiography 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine cardiovascular diseases Prospective Studies Pace mapping Papillary muscle Coronary sinus business.industry Arrhythmias Cardiac Ablation medicine.anatomical_structure Ventricle Cardiology cardiovascular system Catheter Ablation Tachycardia Ventricular business |
| Zdroj: | JACC Clin Electrophysiol |
| Popis: | BACKGROUND: We previously developed an intraprocedural automated site of origin localization system to identify the origin of early left ventricular (LV) activation using 12-lead ECGs. However, it has limitations, as it could not identify the site of origin in the right ventricle (RV), and relied on acquiring a complete electroanatomic map (EAM). OBJECTIVE: The objective of this study was to present a new system, the Automatic Arrhythmia Origin Localization (AAOL) system, which utilized incomplete EAM for localization of idiopathic ventricular arrhythmia (IVA) origin on the patient-specific geometry of LV, RV and neighboring vessels. The accuracy of the system in localizing IVA source sites on cardiac structures where pace-mapping is challenging was assessed. METHODS: Twenty patients undergoing IVA catheter ablation had a 12-lead ECG recorded during clinical arrhythmia and during pacing at various locations identified on EAM geometries. The new system combined 3-lead (III, V2, V6) 120-ms QRS integrals and patient-specific EAM geometry with pace mapping to predict the site of earliest ventricular activation. The predicted site was projected onto EAM geometry. RESULTS: Twenty-three IVA origin sites were clinically identified by activation mapping and/or pace mapping (8 RV; 15 LV, including 8 from the posteromedial papillary muscle; 2 from the aortic root; and 1 from the distal coronary sinus). The new system achieved a mean localization accuracy of 3.6 mm for the 23 mapped IVAs. CONCLUSIONS: The new intraprocedural AAOL system achieved accurate localization of IVA origin in ventricles and neighbouring vessels, which could facilitate ablation procedures for patients with IVAs. Key Words: Idiopathic ventricular arrhythmias (IVA); Premature ventricular complexes (PVCs); idiopathic ventricular tachycardia (IVT); Pace mapping; Activation mapping; Radiofrequency (RF) Ablation; ECG. |
| Databáze: | OpenAIRE |
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