Method to predict isthmus location in ventricular tachycardia caused by reentry with a double-loop pattern.

Method to Predict Isthmus Location. Background:During electrophysiologic study, induction and mapping of clinical reentrant ventricular tachycardia can be difficult. Hence, analysis of sinus-rhythm electrograms for reentry localization is of potential clinical relevance. Herein is described a method...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 16; no. 5; pp. 528 - 537
Autores principales: Ciaccio EJ, Tosti AC, Scheinman MM
Formato: research Journal Article
Publicado: Wiley-Blackwell May2005
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2005
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1046/j.1540-8167.2005.40638.x
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        atl: Method to predict isthmus location in ventricular tachycardia caused by reentry with a double-loop pattern.
      aug:
        au:
          Ciaccio EJ
          Tosti AC
          Scheinman MM
      sug:
        subj:
          Electrocardiography Methods
          Tachycardia, Supraventricular Complications
          Tachycardia, Supraventricular Physiopathology
          Tachycardia, Ventricular Physiopathology
          Algorithms
          Animal Studies
          Dogs
          Heart Conduction System Physiopathology
          Heart Function Tests
          Reproducibility of Results
          Tachycardia, Ventricular Etiology
      ab: Method to Predict Isthmus Location. Background:During electrophysiologic study, induction and mapping of clinical reentrant ventricular tachycardia can be difficult. Hence, analysis of sinus-rhythm electrograms for reentry localization is of potential clinical relevance. Herein is described a method of sinus-rhythm electrogram shape analysis, that does not require arbitrary threshold values, for localization of double-loop reentrant circuits that drive clinical tachycardias.Methods and Results:Reentrant ventricular tachycardia was induced by premature stimulation in 23 postinfarction canine hearts 4-5 days after left anterior descending (LAD) ligation. Sinus-rhythm activation maps were constructed from bipolar electrograms acquired at 196-312 sites in the epicardial border zone. The timing of all electrogram peak deflections during one cycle of sinus rhythm was determined, and the mean (MPD) and deviation (DPD) were taken, respectively, as estimates of the time of activation wavefront crossing, and the duration of local electrical activity. These variables were then mapped on a computerized grid. The line of most uniform and sharp MPD gradient predicted the propagation direction through the double-loop reentrant circuit isthmus that would occur upon tachycardia induction. The sharpest transitions in DPD bounding this line predicted the positions of arcs of block that would border the reentrant circuit isthmus during tachycardia. The actual and estimated isthmuses overlapped by a mean of 84.1± 3.8%. In six experiments lacking inducible reentrant tachycardia, no line of sharp MPD gradient was present in the MPD maps.Conclusions:Analysis of multiple sinus-rhythm deflections can localize the reentrant ventricular tachycardia isthmus without introduction of arbitrary threshold points and peak choices that may lead to error.(J Cardiovasc Electrophysiol, Vol. 16, pp. 1-9, May 2005)
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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