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Electro Anatomical Mapping

Claudia Crocini, Cecilia Ferrantini, Raffaele Coppini, Marina Scardigli, Ping Yan, Leslie M Loew, Godfrey Smith, Elisabetta Cerbai, Corrado Poggesi, Francesco S Pavone, Leonardo Sacconi
Current rescue therapies for life-threatening arrhythmias ignore the pathological electro-anatomical substrate and base their efficacy on a generalized electrical discharge. Here, we developed an all-optical platform to examine less invasive defibrillation strategies. An ultrafast wide-field macroscope was developed to optically map action potential propagation with a red-shifted voltage sensitive dye in whole mouse hearts. The macroscope was implemented with a random-access scanning head capable of drawing arbitrarily-chosen stimulation patterns with sub-millisecond temporal resolution allowing precise epicardial activation of Channelrhodopsin2 (ChR2)...
October 17, 2016: Scientific Reports
Bingbo Hou, Lihui Zheng, Guodong Niu, Lingmin Wu, Yu Qiao, Wei Sun, Ligang Ding, Gang Chen, Shu Zhang, Reginald Liew, Yan Yao
AIMS: This study was aimed to report the characteristics and treatment of ventricular tachycardia (VT) following surgical treatment of pulmonary stenosis with intact ventricular septum. METHODS AND RESULTS: Five patients underwent radiofrequency catheter ablation for sustained monomorphic left bundle branch block (LBBB) type VT who previously underwent surgical treatment of pulmonary stenosis. Except stimulation, voltage and activation mapping was performed using three-dimensional (3D) electro-anatomic mapping and ablation was applied accordingly...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Fabio Quartieri, Daniele Giacopelli, Matteo Iori, Nicola Bottoni
In this case report, we look into the implant procedure of a single-lead ICD with floating atrial sensing dipole in a pregnant woman, without using fluoroscopy. This system benefits the proper positioning of the lead. This is possible thanks to the simultaneous display of both the atrial and ventricular dipoles on the electro-anatomical mapping system. This technique may be taken into consideration for the few rare cases where fluoroscopy is absolutely contraindicated.
March 2016: Indian Pacing and Electrophysiology Journal
Uyên Châu Nguyên, Masih Mafi-Rad, Jean-Paul Aben, Martijn W Smulders, Elien B Engels, Antonius M W van Stipdonk, Justin G L M Luermans, Sebastiaan C A M Bekkers, Frits W Prinzen, Kevin Vernooy
BACKGROUND: Placing the left ventricular (LV) lead at a site of late electrical activation remote from scar is desired to improve cardiac resynchronization therapy (CRT) response. OBJECTIVE: To integrate coronary venous electro-anatomic mapping (EAM) with delayed enhancement cardiac magnetic resonance (DE-CMR) enabling LV lead guidance to the latest activated vein remote from scar. METHODS: Eighteen CRT candidates with focal scar on DE-CMR were prospectively included...
September 20, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Sandeep A Saha, Kousik Krishnan, Christopher Madias, Richard G Trohman
A 34-year-old man with Brugada syndrome (BrS) presented with electrical storm, manifested as multiple appropriate shocks from his implantable cardioverter-defibrillator over a period of 7 hours. He had not tolerated prior treatment with quinidine, and had self-discontinued cilostazol citing persistent palpitations. After stabilization with intravenous isoproterenol, an electrophysiology study was performed but no spontaneous or induced ventricular ectopic beats were identified. A three-dimensional (3D) endocardial electro-anatomic map of the right ventricular outflow tract (RVOT), pulmonic valve, and pulmonary artery, as well as a 3D epicardial map of the RVOT, were created...
September 19, 2016: Cardiology and Therapy
Tarek Zghaib, Esra Gucuk Ipek, Sohail Zahid, Muhammad Adnan Balouch, Satish Misra, Hiroshi Ashikaga, Ronald D Berger, Joseph E Marine, David D Spragg, Stefan L Zimmerman, Vadim Zipunnikov, Natalia Trayanova, Hugh Calkins, Saman Nazarian
BACKGROUND: Epicardial adipose tissue (EAdT) is metabolically active and likely contributes to atrial fibrillation (AF) through the release of inflammatory cytokines into the myocardium or through its rich innervation with ganglionated plexi at the pulmonary vein ostia. The electrophysiologic mechanisms underlying the association between EAdT and AF remain unclear. OBJECTIVE: The purpose of this study was to investigate the association of EAdT with adjacent myocardial substrate...
August 19, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Vishal Luther, Nick W F Linton, Shahnaz Jamil-Copley, Michael Koa-Wing, Phang Boon Lim, Norman Qureshi, Fu Siong Ng, Sajad Hayat, Zachary Whinnett, D Wyn Davies, Nicholas S Peters, Prapa Kanagaratnam
BACKGROUND: Post-infarct ventricular tachycardia is associated with channels of surviving myocardium within scar characterized by fractionated and low-amplitude signals usually occurring late during sinus rhythm. Conventional automated algorithms for 3-dimensional electro-anatomic mapping cannot differentiate the delayed local signal of conduction within the scar from the initial far-field signal generated by surrounding healthy tissue. Ripple mapping displays every deflection of an electrogram, thereby providing fully informative activation sequences...
June 2016: Circulation. Arrhythmia and Electrophysiology
Milena Leo, Michala F Pedersen, Kim Rajappan, Matthew Ginks, Yaver Bashir, Timothy R Betts
AIMS: Oesophageal temperature monitoring is currently used during atrial fibrillation (AF) ablation to prevent atrio-oesophageal fistula. The aim of our study was to investigate if oesophageal temperature alerts, leading to early termination of radiofrequency (RF) energy and/or reduction in power during pulmonary vein isolation, can promote pulmonary vein reconnection (PVR). METHODS AND RESULTS: Patients undergone two consecutive AF ablation procedures with a three-dimensional electro-anatomical mapping system and oesophageal temperature monitoring were studied...
May 31, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Antonio R Porras, Gemma Piella, Antonio Berruezo, Juan Fernández-Armenta, Alejandro F Frangi
Merging multimodal information about myocardial scar tissue can help electrophysiologists to find the most appropriate target during catheter ablation of ventricular arrhythmias. A framework is presented to analyze and combine information from delayed enhancement magnetic resonance imaging (DE-MRI) and electro-anatomical mapping data. Using this information, electrical, mechanical, and image-based characterization of the myocardium are performed. The presented framework allows the left ventricle to be segmented by DE-MRI and the scar to be characterized prior to the intervention based on image information...
2014: IEEE Journal of Translational Engineering in Health and Medicine
Jien-Jiun Chen, Fu-Chun Chiu, Su-Kiat Chua, Chieh-Cheh Yu, Lian-Yu Lin, Chia-Ti Tsai, Ling-Ping Lai, Jiunn-Lee Lin
BACKGROUND: Atrial fibrillation (AF) is the most common heart rhythm disorder in adults. Currently, use of the circumferential pulmonary vein isolation (CPVI) technique is the cornerstone of ablation therapy for paroxysmal atrial fibrillation. In this report, we described our ablation strategy and outcomes when treating a limited number of AF patients. METHODS: This study enrolled patients with paroxysmal or persistent AF that were resistant to at least one anti-arrhythmia drug...
September 2013: Acta Cardiol Sin
Andres Orozco-Duque, John Bustamante, German Castellanos-Dominguez
BACKGROUND: Electrogram-guided ablation procedures have been proposed as an alternative strategy consisting of either mapping and ablating focal sources or targeting complex fractionated electrograms in atrial fibrillation (AF). However, the incomplete understanding of the mechanism of AF makes difficult the decision of detecting the target sites. To date, feature extraction from electrograms is carried out mostly based on the time-domain morphology analysis and non-linear features. However, their combination has been reported to achieve better performance...
2016: Biomedical Engineering Online
Apinya Bharmanee, Srinath Gowda, Harinder R Singh
BACKGROUND: Use of nonfluoroscopic 3-dimensional electroanatomic mapping (NF-3DEAM) in patients with congenital heart defects (CHDs) is not well reported. OBJECTIVE: The purpose of this study was to evaluate the feasibility, accuracy, and safety of NF-3DEAM in patients with CHDs. METHODS: Retrospective review of electrophysiologic study (EPS) in patients with CHD from 2009 to 2013 was conducted. Patients undergoing EPS with NF-3DEAM using the EnSite NavX system (St...
August 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Zhong Chen, Rocio Cabrera-Lozoya, Jatin Relan, Manav Sohal, Anoop Shetty, Rashed Karim, Herve Delingette, Jaswinder Gill, Kawal Rhode, Nicholas Ayache, Peter Taggart, Christopher Aldo Rinaldi, Maxime Sermesant, Reza Razavi
INTRODUCTION: Computational modeling of cardiac arrhythmogenesis and arrhythmia maintenance has made a significant contribution to the understanding of the underlying mechanisms of arrhythmia. We hypothesized that a cardiac model using personalized electro-anatomical parameters could define the underlying ventricular tachycardia (VT) substrate and predict reentrant VT circuits. We used a combined modeling and clinical approach in order to validate the concept. METHODS AND RESULTS: Non-contact electroanatomic mapping studies were performed in 7 patients (5 ischemics, 2 non-ischemics)...
July 2016: Journal of Cardiovascular Electrophysiology
David Soto-Iglesias, Constantine Butakoff, David Andreu, Juan Fernández-Armenta, Antonio Berruezo, Oscar Camara
Integration of electrical and structural information for scar characterization in the left ventricle (LV) is a crucial step to better guide radio-frequency ablation therapies, which are usually performed in complex ventricular tachycardia (VT) cases. This integration requires finding a common representation where to map the electrical information from the electro-anatomical map (EAM) surfaces and tissue viability information from delay-enhancement magnetic resonance images (DE-MRI). However, the development of a consistent integration method is still an open problem due to the lack of a proper evaluation framework to assess its accuracy...
August 2016: Medical Image Analysis
Tanja Kurzendorfer, Philip W Mewes, Andreas Maier, Norbert Strobel, Alexander Brost
Cryo-balloon catheters have attracted an increasing amount of interest in the medical community as they can reduce patient risk during left atrial pulmonary vein ablation procedures. As cryo-balloon catheters are not equipped with electrodes, they cannot be localized automatically by electro-anatomical mapping systems. As a consequence, X-ray fluoroscopy has remained an important means for guidance during the procedure. Most recently, image guidance methods for fluoroscopy-based procedures have been proposed, but they provide only limited support for cryo-balloon catheters and require significant user interaction...
August 2016: IEEE Transactions on Medical Imaging
Andrea Colella, Marzia Giaccardi, Tommaso Colella, Pietro Amedeo Modesti
BACKGROUND: Fluoroscopic guidance is the standard tool used in device implantation. This means that both the patient and the operator are exposed to radiation, which may sometimes be high. The possibility of single-lead permanent pacemaker implantation without fluoroscopy has already been demonstrated. OBJECTIVE: The aim of our study was to investigate the feasibility and reliability of biventricular device implantation guided only by an electroanatomic navigation system...
July 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Antonio Esposito, Anna Palmisano, Sofia Antunes, Giuseppe Maccabelli, Caterina Colantoni, Paola Maria Vittoria Rancoita, Francesca Baratto, Clelia Di Serio, Giovanna Rizzo, Francesco De Cobelli, Paolo Della Bella, Alessandro Del Maschio
OBJECTIVES: This study sought to compare myocardial scars depicted by computed tomography (CT) with electrical features from electro-anatomic mapping (EAM), assessing the potential role of CT integration in ventricular tachycardia (VT) and radiofrequency catheter ablation (RFCA) procedures. BACKGROUND: Imaging-based characterization of VT myocardial substrate is required to plan EAM and, potentially, to guide RFCA. METHODS: Forty-two consecutive patients, 35 of whom had implantable cardioverter-defibrillator, all referred for VT RFCA, underwent pre-procedural CT including an angiographic and a 10-min delayed-enhancement scan...
July 2016: JACC. Cardiovascular Imaging
Lakshmi Nagaraju, Dipika Menon, Peter F Aziz
BACKGROUND: Radiation exposure related to medical procedures carries known medical risk. Electrophysiology (EP) and catheter ablation procedures are traditionally performed under fluoroscopic guidance. Three-dimensional (3D) electroanatomical navigation systems decrease or eliminate fluoroscopy use in EP procedures. OBJECTIVE: The aim of this study was to assess the efficacy and outcome of a minimal or no fluoroscopic electroanatomical mapping approach for catheter ablations for supraventricular tachycardia (SVT) in the pediatric population...
June 2016: Pacing and Clinical Electrophysiology: PACE
Rishi Anand, Maxim V Gorev, Hermine Poghosyan, Lindsay Pothier, John Matkins, Gregory Kotler, Sarah Moroz, James Armstrong, Sergei V Nemtsov, Michael V Orlov
PURPOSE: To compare the efficacy and accuracy of rotational angiography with three-dimensional reconstruction (3DATG) image merged with electro-anatomical mapping (EAM) vs. CT-EAM. METHODS: A prospective, randomized, parallel, two-center study conducted in 36 patients (25 men, age 65 ± 10 years) undergoing AF ablation (33 % paroxysmal, 67 % persistent) guided by 3DATG (group 1) vs. CT (group 2) image fusion with EAM. 3DATG was performed on the Philips Allura Xper FD 10 system...
August 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Caroline H Roney, Konstantinos N Tzortzis, Chris D Cantwell, Norman A Qureshi, Rheeda L Ali, Phang Boon Lim, Jennifer H Siggers, Fu Siong Ng, Nicholas S Peters
Electro-anatomic mapping and medical imaging systems, used during clinical procedures for treatment of atrial arrhythmias, frequently record and display measurements on an anatomical surface of the left atrium. As such, obtaining a complete picture of activation necessitates simultaneous views from multiple angles. In addition, post-processing of three-dimensional surface data is challenging, since algorithms are typically applicable to planar or volumetric data. We applied a surface flattening methodology to medical imaging data and electro-anatomic mapping data to generate a two-dimensional representation that best preserves distances, since the calculation of many clinically relevant metrics, including conduction velocity and rotor trajectory identification require an accurate representation of distance...
2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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