Prospective Assessment of an Automated Intraprocedural 12-Lead ECG-Based System for Localization of Early Left Ventricular Activation

Autor: Ciorsti MacIntyre, James W. Warren, John L. Sapp, Rajin Choudhury, Paul J. MacInnis, Amir AbdelWahab, Curtis Marcoux, Ratika Parkash, Shijie Zhou, Jason Davis, C. Gray, M. Gardner, Natalia A. Trayanova, David Lee, B. Milan Horacek, Ihab Elsokkari
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
12 lead ecg
Action Potentials
Catheter ablation
030204 cardiovascular system & hematology
Ventricular tachycardia
Article
Automation
Electrocardiography
03 medical and health sciences
0302 clinical medicine
Heart Conduction System
Heart Rate
Predictive Value of Tests
Physiology (medical)
Internal medicine
medicine
Humans
Prospective Studies
030212 general & internal medicine
Aged
Site of origin
Aged
80 and over
medicine.diagnostic_test
business.industry
Reproducibility of Results
Signal Processing
Computer-Assisted
Middle Aged
medicine.disease
Ablation
Ventricular activation
Catheter Ablation
Tachycardia
Ventricular
Cardiology
Female
Localization system
Electrophysiologic Techniques
Cardiac
Cardiology and Cardiovascular Medicine
business
Zdroj: Circ Arrhythm Electrophysiol
ISSN: 1941-3084
1941-3149
DOI: 10.1161/circep.119.008262
Popis: Background: To facilitate ablation of ventricular tachycardia (VT), an automated localization system to identify the site of origin of left ventricular activation in real time using the 12-lead ECG was developed. The objective of this study was to prospectively assess its accuracy. Methods: The automated site of origin localization system consists of 3 steps: (1) localization of ventricular segment based on population templates, (2) population-based localization within a segment, and (3) patient-specific site localization. Localization error was assessed by the distance between the known reference site and the estimated site. Results: In 19 patients undergoing 21 catheter ablation procedures of scar-related VT, site of origin localization accuracy was estimated using 552 left ventricular endocardial pacing sites pooled together and 25 VT-exit sites identified by contact mapping. For the 25 VT-exit sites, localization error of the population-based localization steps was within 10 mm. Patient-specific site localization achieved accuracy of within 3.5 mm after including up to 11 pacing (training) sites. Using 3 remotes (67.8±17.0 mm from the reference VT-exit site), and then 5 close pacing sites, resulted in localization error of 7.2±4.1 mm for the 25 identified VT-exit sites. In 2 emulated clinical procedure with 2 induced VTs, the site of origin localization system achieved accuracy within 4 mm. Conclusions: In this prospective validation study, the automated localization system achieved estimated accuracy within 10 mm and could thus provide clinical utility.
Databáze: OpenAIRE
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