Localization of the isthmus in reentrant circuits by analysis of electrograms derived from clinical noncontact mapping during sinus rhythm and ventricular tachycardia.
Reentrant Circuit Isthmus Location. Introduction: New methods for electrogram analysis accurately estimated reentrant circuit isthmus location and shape in a canine model. It was hypothesized that these methods also would locate reentrant circuits causing clinical ventricular tachycardia (VT). Metho...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 15; no. 1; pp. 27 - 37 |
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| Autores principales: | , , , , |
| Formato: | clinical trial research Journal Article |
| Publicado: |
Wiley-Blackwell
Jan2004
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106080789&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106080789 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Jan2004 vid: 15 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106080789 2009392213 10.1046/j.1540-8167.2004.03134.x NLM15028069 106080789 ppf: 27 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Localization of the isthmus in reentrant circuits by analysis of electrograms derived from clinical noncontact mapping during sinus rhythm and ventricular tachycardia. aug: au: Ciaccio EJ Chow AW Davies CW Wit AL Peters NS sug: subj: Algorithms Arrhythmia, Sinus Diagnosis Arrhythmia, Sinus Physiopathology Diagnosis, Computer Assisted Methods Electrocardiography Methods Heart Conduction System Physiopathology Tachycardia, Ventricular Diagnosis Tachycardia, Ventricular Physiopathology Arrhythmia, Sinus Complications Clinical Trials Reproducibility of Results Sensitivity and Specificity Tachycardia, Supraventricular Diagnosis Tachycardia, Supraventricular Etiology Tachycardia, Supraventricular Physiopathology Tachycardia, Ventricular Etiology Human ab: Reentrant Circuit Isthmus Location. Introduction: New methods for electrogram analysis accurately estimated reentrant circuit isthmus location and shape in a canine model. It was hypothesized that these methods also would locate reentrant circuits causing clinical ventricular tachycardia (VT). Methods and Results: Intracardiac electrogram recordings, obtained with a noncontact mapping system, were analyzed retrospectively from 14 patients with reentrant VT who had undergone successful radiofrequency ablation for prevention of VT initiation. Unipolar electrograms from 256 uniformly distributed endocardial sites were reconstructed by mathematical transformation. Twenty-seven tachycardias were mapped; 15 (in 11 patients) had a complete endocardial reentrant circuit with a figure-of-eight conduction pattern. During sinus rhythm, the location and axis of the slowest and most uniform conduction in the region of latest endocardial activation (the primary axis), the limits of which were defined as boundaries with >15 ms difference in electrogram duration between contiguous recordings, identified the location and shape of the reentrant circuit isthmus with a mean sensitivity compared with activation mapping of 79.3% and a mean specificity of 97.6%. The midpoint of a theoretical 'estimated best ablation line' drawn perpendicular to the primary axis of activation, spanning the estimated isthmus location was within 1.3 ± 0.2 cm (mean distance ± SD) of the actual ablation site that terminated tachycardia. Analysis of VT electrograms, based on time shifts in the far-field component of the local electrogram when cycle length changed (piecewise linear adaptive template matching [PLATM] method) in 5 of the cases, accurately estimated the time interval between activation at the recording site and the circuit isthmus slow conduction zone where the effective ablation lesion had been placed, which is proportional to the distance between the two locations (mean difference compared with activation mapping: ±37.3 ms). Conclusion: In selected patients with VT who have a complete endocardial circuit, isthmus location and shape can be discerned by analysis of sinus rhythm or tachycardia electrograms, and an effective ablation site can be predicted without the need to construct activation maps of reentrant circuits. (J Cardiovasc Electrophysiol, Vol. 15, pp. 27-36, January 2004) pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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