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High Resolution Electroanatomical mapping

Christian Sohns, Ardan M Saguner, Christine Lemes, Francesco Santoro, Shibu Mathew, Christian Heeger, Bruno Reißmann, Tilman Maurer, Johannes Riedl, Thomas Fink, Kentaro Hayashi, Feifan Ouyang, Karl-Heinz Kuck, Andreas Metzner
BACKGROUND: The Rhythmia mapping system was recently launched and allows for rapid ultra-high-resolution electroanatomical mapping. We evaluated the feasibility, acute efficacy and safety of this novel system for ablation of atrial fibrillation (AF) and left atrial (LA) tachycardia (AT). METHODS AND RESULTS: A total of 35 consecutive patients (age 64.3 ± 8.6 years, LA diameter 44.4 ± 5.8 mm) underwent catheter ablation for AF and/or AT. All procedures were performed using Rhythmia in conjunction with the Orion mini-basket catheter...
June 11, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Shinsuke Miyazaki, Hiroshi Taniguchi, Hitoshi Hachiya, Hiroaki Nakamura, Takamitsu Takagi, Jin Iwasawa, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: The post-second-generation cryoballoon (CB) ablation isolation area during the chronic phase has not been described. The aim of this study was to quantitatively evaluate the chronic-phase isolation area after 28-mm second-generation CB ablation and compare it to the estimated conventional radiofrequency circumferential pulmonary vein isolation (CPVI) line. METHODS AND RESULTS: Thirty-two patients with paroxysmal atrial fibrillation underwent pulmonary vein (PV) isolation using second-generation CB...
May 2016: Circulation. Arrhythmia and Electrophysiology
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
Andreas Bollmann, Sebastian Hilbert, Silke John, Jedrzej Kosiuk, Gerhard Hindricks
INTRODUCTION: Recently, an automatic, high-resolution mapping system has been presented to accurately and quickly identify right atrial geometry and activation patterns in animals, but human data are lacking. This study aims to assess the clinical feasibility and accuracy of high-density electroanatomical mapping of various RA arrhythmias. METHODS AND RESULTS: Electroanatomical maps of the RA (35 partial and 24 complete) were created in 23 patients using a novel mini-basket catheter with 64 electrodes and automatic electrogram annotation...
February 2016: Journal of Cardiovascular Electrophysiology
Amit K Mehrotra, David Callans
Treatment for ventricular tachycardia (VT) generally includes 1 or more of the following options: antiarrhythmic therapy, an implantable cardioverter-defibrillator and/or catheter ablation. Catheter ablation is performed with an electroanatomic mapping system to define the heart's 3D anatomy, as well as regions of scar. Radiofrequency energy is then applied to areas of abnormal substrate within which are located channels critical to the VT circuit. Cardiac magnetic resonance (CMR) imaging is a non-invasive modality that provides high-resolution images of cardiac structure and function...
2015: Circulation Journal: Official Journal of the Japanese Circulation Society
Sok-Sithikun Bun, Decebal Gabriel Latcu, Francis Marchlinski, Nadir Saoudi
Since its first description about one century ago, our understanding of atrial flutter (AFL) circuits has considerably evolved. One AFL circuit can have variable electrocardiographic (ECG) manifestations depending on the presence of pre-existing atrial lesions, or impaired atrial substrate. Conversely, different (right sided or even left sided) atrial circuits including different mechanisms (macroreentrant, microreentrant, or focal) can present with a very similar surface ECG manifestation. The development of efficient high-resolution electroanatomical mapping systems has improved our knowledge about AFL mechanisms, as well as facilitated their curative treatment with radiofrequency catheter ablation...
September 14, 2015: European Heart Journal
Anees Thajudeen, Warren M Jackman, Brian Stewart, Ivan Cokic, Hiroshi Nakagawa, Michael Shehata, Allen M Amorn, Avinash Kali, Ezh Liu, Doron Harlev, Nathan Bennett, Rohan Dharmakumar, Sumeet S Chugh, Xunzhang Wang
BACKGROUND: Endocardial mapping for scars and abnormal electrograms forms the most essential component of ventricular tachycardia ablation. The utility of ultra-high resolution mapping of ventricular scar was assessed using a multielectrode contact mapping system in a chronic canine infarct model. METHODS: Chronic infarcts were created in five anesthetized dogs by ligating the left anterior descending coronary artery. Late gadolinium-enhanced magnetic resonance imaging (LGE MRI) was obtained 4...
June 2015: Pacing and Clinical Electrophysiology: PACE
Andreas Bollmann, Sebastian Hilbert, Silke John, Jedrzej Kosiuk, Gerhard Hindricks
AIMS: Although sinus node modification by catheter ablation is an established therapy for the treatment of inappropriate sinus tachycardia, there is incomplete understanding of sinus node anatomy and function but also limited electroanatomical mapping data. Recently, an automatic, ultra high-resolution mapping system has been presented to accurately and quickly identify right atrial (RA) geometry and activation patterns but detailed assessment of sinus node activation has not been performed which was one aim of this study...
March 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Ursa Mikuz, Gregor Poglajen, Misa Fister, Vito Starc, Joseph C Wu, Henry Hsia, François Haddad, Bojan Vrtovec
BACKGROUND: We analyzed electromechanical mismatch (EMM) and its relationship to ventricular repolarization in patients with nonischemic dilated cardiomyopathy (DCM). METHODS AND RESULTS: In 39 DCM patients with left ventricular ejection fraction (LVEF) <40% and New York Heart Association functional class ≥III, electroanatomic mapping was used to quantify areas of EMM. High-resolution electrocardiograph was used to measure heart rate variability (HRV) and QT variability index (QTVI)...
December 2014: Journal of Cardiac Failure
Oleh Dzyubachyk, Qian Tao, Dirk H J Poot, Hildo J Lamb, Katja Zeppenfeld, Boudewijn P F Lelieveldt, Rob J van der Geest
PURPOSE: To develop and validate a method for improving image resolution of late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) for accurate assessment of myocardial scar. MATERIALS AND METHODS: In a cohort of 37 postinfarction patients, LGE was performed prior to ventricular tachycardia catheter ablation therapy at 1.5T. A super-resolution reconstruction (SRR) technique was applied to the three anisotropic views: short-axis (SA), two-chamber, and four-chamber, to reconstruct a single isotropic volume...
July 2015: Journal of Magnetic Resonance Imaging: JMRI
Yasuaki Tanaka, Martin Genet, Lik Chuan Lee, Alastair J Martin, Richard Sievers, Edward P Gerstenfeld
BACKGROUND: Standard electroanatomic mapping systems use a single catheter to perform left ventricular substrate mapping. A new mapping system uses a 64-electrode mini-basket catheter to perform rapid automated acquisition of chamber geometry, voltage, and activation. OBJECTIVE: The aim of this study was to compare the accuracy of electroanatomic mapping using the basket catheter with that of mapping using a standard linear catheter in a swine model of chronic myocardial infarction...
January 2015: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Yuki Komatsu, Amir Jadidi, Frederic Sacher, Arnaud Denis, Matthew Daly, Nicolas Derval, Ashok Shah, Heiko Lehrmann, Chan-Il Park, Reinhold Weber, Thomas Arentz, Gregor Pache, Maxime Sermesant, Nicholas Ayache, Jatin Relan, Michel Montaudon, François Laurent, Mélèze Hocini, Michel Haïssaguerre, Pierre Jaïs, Hubert Cochet
BACKGROUND: Myocardial fibrofatty infiltration is a milieu for ventricular tachycardia (VT) in arrhythmogenic right ventricular cardiomyopathy (ARVC) and can be depicted as myocardial hypodensity on contrast-enhanced multidetector computed tomography (MDCT) with high spatial and temporal resolution. This study aimed to assess the relationship between MDCT-imaged myocardial fat and VT substrate in ARVC. METHODS AND RESULTS: We studied 16 patients with ARVC who underwent ablation and preprocedural MDCT...
August 2014: Journal of the American Heart Association
Michael Seger, Friedrich Hanser, Wolfgang Dichtl, Markus Stuehlinger, Florian Hintringer, Thomas Trieb, Bernhard Pfeifer, Thomas Berger
AIMS: The present study was aimed to assess epi- and endocardial ventricular electroanatomical activation during cardiac resynchronization therapy (CRT) by means of non-invasive imaging of cardiac electrophysiology (NICE) in a patient with a novel quadripolar LV lead. METHODS AND RESULTS: Non-invasive imaging of cardiac electrophysiology is a novel imaging tool which works by fusing data from high-resolution electrocardiogram (ECG) mapping with a model of the patient's individual cardiothoracic anatomy created from magnetic resonance imaging...
May 2014: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Maryam E Rettmann, David R Holmes, David M Kwartowitz, Mia Gunawan, Susan B Johnson, Jon J Camp, Bruce M Cameron, Charles Dalegrave, Mark W Kolasa, Douglas L Packer, Richard A Robb
PURPOSE: In cardiac ablation therapy, accurate anatomic guidance is necessary to create effective tissue lesions for elimination of left atrial fibrillation. While fluoroscopy, ultrasound, and electroanatomic maps are important guidance tools, they lack information regarding detailed patient anatomy which can be obtained from high resolution imaging techniques. For this reason, there has been significant effort in incorporating detailed, patient-specific models generated from preoperative imaging datasets into the procedure...
February 2014: Medical Physics
Ivan Cokic, Avinash Kali, Xunzhang Wang, Hsin-Jung Yang, Richard L Q Tang, Anees Thajudeen, Michael Shehata, Allen M Amorn, Enzhao Liu, Brian Stewart, Nathan Bennett, Doron Harlev, Sotirios A Tsaftaris, Warren M Jackman, Sumeet S Chugh, Rohan Dharmakumar
PURPOSE: Iron deposition has been shown to occur following myocardial infarction (MI). We investigated whether such focal iron deposition within chronic MI lead to electrical anomalies. METHODS: Two groups of dogs (ex-vivo (n = 12) and in-vivo (n = 10)) were studied at 16 weeks post MI. Hearts of animals from ex-vivo group were explanted and sectioned into infarcted and non-infarcted segments. Impedance spectroscopy was used to derive electrical permittivity ([Formula: see text]) and conductivity ([Formula: see text])...
2013: PloS One
Juan Fernández-Armenta, Antonio Berruezo, David Andreu, Oscar Camara, Etelvino Silva, Luis Serra, Valeria Barbarito, Luigi Carotenutto, Reinder Evertz, José T Ortiz-Pérez, Teresa María De Caralt, Rosario Jesús Perea, Marta Sitges, Lluis Mont, Alejandro Frangi, Josep Brugada
BACKGROUND: Conducting channels are the target for ventricular tachycardia (VT) ablation. Conducting channels could be identified with contrast enhanced-cardiac magnetic resonance (ce-CMR) as border zone (BZ) corridors. A 3-dimensional (3D) reconstruction of the ce-CMR could allow visualization of the 3D structure of these BZ channels. METHODS AND RESULTS: We included 21 patients with healed myocardial infarction and VT. A 3D high-resolution 3T ce-CMR was performed before CARTO-guided VT ablation...
June 2013: Circulation. Arrhythmia and Electrophysiology
Yuki Komatsu, Hubert Cochet, Amir Jadidi, Frédéric Sacher, Ashok Shah, Nicolas Derval, Daniel Scherr, Patrizio Pascale, Laurent Roten, Arnaud Denis, Khaled Ramoul, Shinsuke Miyazaki, Matthew Daly, Matthieu Riffaud, Maxime Sermesant, Jatin Relan, Nicholas Ayache, Steven Kim, Michel Montaudon, François Laurent, Mélèze Hocini, Michel Haïssaguerre, Pierre Jaïs
BACKGROUND: A majority of patients undergoing ablation of ventricular tachycardia have implanted devices precluding substrate imaging with delayed-enhancement MRI. Contrast-enhanced multidetector computed tomography (MDCT) can depict myocardial wall thickness with submillimetric resolution. We evaluated the relationship between regional myocardial wall thinning (WT) imaged by MDCT and arrhythmogenic substrate in postinfarction ventricular tachycardia. METHODS AND RESULTS: We studied 13 consecutive postinfarction patients undergoing MDCT before ablation...
April 2013: Circulation. Arrhythmia and Electrophysiology
Sebastien Roujol, Tamer A Basha, Alex Tan, Varun Khanna, Raymond H Chan, Mehdi H Moghari, Hussein Rayatzadeh, Jaime L Shaw, Mark E Josephson, Reza Nezafat
Electroanatomical voltage mapping (EAVM) is commonly performed prior to catheter ablation of scar-related ventricular tachycardia (VT) to locate the arrhythmic substrate and to guide the ablation procedure. EAVM is used to locate the position of the ablation catheter and to provide a 3-D reconstruction of left-ventricular anatomy and scar. However, EAVM measurements only represent the endocardial scar with no transmural or epicardial information. Furthermore, EAVM is a time-consuming procedure, with a high operator dependence and has low sampling density, i...
May 2013: IEEE Transactions on Bio-medical Engineering
Andrew M Crean, Danna A Spears, Adrian M Suszko, Vijay S Chauhan
Scar delineation with late gadolinium-enhanced MRI can direct VT substrate mapping and ablation, but imaging is poor and relatively contraindicated in the majority of patients with ICDs. We present a case of scar definition using late iodine-enhanced multidetector CT in a patient with ischemic cardiomyopathy and multiple ICD shocks for VT. CT images were acquired using a novel intracoronary contrast delivery protocol which provided high-resolution subendocardial scar visualization. The segmented scar images were subsequently imported into an electroanatomic mapping platform to guide successful VT ablation...
June 2013: Journal of Cardiovascular Electrophysiology
Leon M Ptaszek, Fadi Chalhoub, Francesco Perna, Roy Beinart, Conor D Barrett, Stephan B Danik, E Kevin Heist, Jeremy N Ruskin, Moussa Mansour
PURPOSE: Conventional electroanatomical mapping systems employ roving catheters with one or a small number of electrodes. Maps acquired using these systems usually contain a small number of points and take a long time to acquire. Use of a multielectrode catheter could facilitate rapid acquisition of higher-resolution maps through simultaneous collection of data from multiple points in space; however, a large multielectrode array could potentially limit catheter maneuverability. The purpose of this study was to test the feasibility of using a novel, multielectrode catheter to map the right atrium and the left ventricle...
April 2013: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
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