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Unipolar mapping

Iosif Kelesidis, Benoit Desjardins, Daniele Muser, Pasquale Santangeli, Erica S Zado, Francis E Marchlinski
INTRODUCTION: Unipolar voltage mapping through its wider "field of view" can identify substrate deeper to the endocardium on the right ventricular (RV) free wall and left ventricle. The reference value(s) for normal endocardial (ENDO) unipolar voltage (UNI) for the septal aspect of the right ventricle (RV) and the effect of the aortic root that is directly opposed to the posterior septal plane of the RV outflow tract (RVOT) have not been established. METHODS AND RESULTS: We performed detailed (185 ± 70, range 127-342 points) RV ENDO UNI maps in 9 patients without structural heart disease; 6 had magnetic resonance (MR) imaging; 5 were males; the mean age was 49 ± 11 years...
May 4, 2018: Journal of Cardiovascular Electrophysiology
Linwei Wang, Omar A Gharbia, Saman Nazarian, B Milan Horácek, John L Sapp
Aims: Contact mapping is currently used to guide catheter ablation of scar-related ventricular tachycardia (VT) but usually provides incomplete assessment of 3D re-entry circuits and their arrhythmogenic substrates. This study investigates the feasibility of non-invasive electrocardiographic imaging (ECGi) in mapping scar substrates and re-entry circuits throughout the epicardium and endocardium. Methods and results: Four patients undergoing endocardial and epicardial mapping and ablation of scar-related VT had computed tomography scans and a 120-lead electrocardiograms, which were used to compute patient-specific ventricular epicardial and endocardial unipolar electrograms (CEGMs)...
April 18, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Zhuo Liang, Xuejun Ren, Tao Zhang, Zhihong Han, Jianzeng Dong, Yunlong Wang
PURPOSE: We assessed conventional and reversed U curve methods for mapping and ablation of RVOT-type VAs. METHODS: Single-center data were reviewed from consecutive cases of symptomatic VAs of RVOT-type origin that were mapped and ablated successfully using conventional method in RVOT (pulmonary artery might be included) from January 2014 to December 2015 (cohort 1, n = 75) or conventional method in RVOT and reversed U curve in PSC (for first ablation attempt) from January 2016 to March 2017 (cohort 2, n = 60)...
June 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Michele Orini, Peter Taggart, Pier D Lambiase
INTRODUCTION: The unipolar electrogram (UEG) provides local measures of cardiac activation and repolarization and is an important translational link between patient and laboratory. A simple theoretical model of the UEG was previously proposed and tested in-silico. METHOD AND RESULTS: The aim of this study was to use epicardial sock-mapping data to validate the simple model's predictions of unipolar electrogram morphology in the in-vivo human heart. The simple model conceptualizes the UEG as the difference between a local cardiac action potential and a position-independent component representing remote activity, which is defined as the average of all action potentials...
April 16, 2018: Journal of Cardiovascular Electrophysiology
Claire A Glashan, Alexander F A Androulakis, Qian Tao, Ross N Glashan, Lambertus J Wisse, Micaela Ebert, Marco C de Ruiter, Berend J van Meer, Charlotte Brouwer, Olaf M Dekkers, Daniel A Pijnappels, Jacques M T de Bakker, Marta de Riva, Sebastiaan R D Piers, Katja Zeppenfeld
Aims: Electroanatomical voltage mapping (EAVM) is an important diagnostic tool for fibrosis identification and risk stratification in non-ischaemic cardiomyopathy (NICM); currently, distinct cut-offs are applied. We aimed to evaluate the performance of EAVM to detect fibrosis by integration with whole heart histology and to identify the fibrosis pattern in NICM patients with ventricular tachycardias (VTs). Methods and results: Eight patients with NICM and VT underwent EAVM prior to death or heart transplantation...
March 29, 2018: European Heart Journal
Jonathan Chrispin, Harikrishna Tandri
No abstract text is available yet for this article.
March 30, 2018: Pacing and Clinical Electrophysiology: PACE
F C W van Krugten, M Goorden, A J L M van Balkom, J Spijker, W B F Brouwer, L Hakkaart-van Roijen
BACKGROUND: Early identification of the subgroup of patients with major depressive disorder (MDD) in need of highly specialized care could enhance personalized intervention. This, in turn, may reduce the number of treatment steps needed to achieve and sustain an adequate treatment response. The aim of this study was to identify patient-related indicators that could facilitate the early identification of the subgroup of patients with MDD in need of highly specialized care. METHODS: Initial patient indicators were derived from a systematic review...
March 25, 2018: Depression and Anxiety
Chung-Hsing Lin, Li-Wei Lo, Yenn-Jiang Lin, Shih-Lin Chang, Yu-Feng Hu, Ta-Chuan Tuan, Hung-Kai Huang, Cheng-Hung Chiang, Suresh Allamsetty, Jo-Nan Liao, Fa-Po Chung, Yao-Ting Chang, Chin-Yu Lin, Abigail Louise D Te, Shinya Yamada, Rohit Walia, Yuan Hung, Shih-Ann Chen
PURPOSE: There are few reports describing ventricular arrhythmias (VAs) from the crux and the corresponding endocardial site, i.e., the basal inferior segment of the interventricular septum (IVS). We aimed to investigate a distinct clinical group of VAs arising from the endocardium at this area in patients with structural heart diseases (SHD). METHODS: We included 17 patients with SHD and clinically documented VAs. Thirteen patients underwent endocardial mapping only...
March 23, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Elvis Teijeira-Fernandez, Hubert Cochet, Felix Bourier, Masateru Takigawa, Ghassen Cheniti, Nathaniel Thompson, Antonio Frontera, Claudia Camaioni, Gregoire Massouille, Zakaria Jalal, Nicolas Derval, Xavier Iriart, Arnaud Denis, Meleze Hocini, Michel Haissaguerre, Pierre Jais, Jean-Benoit Thambo, Frederic Sacher
BACKGROUND: Voltage criteria for ventricular mapping have been obtained from small series of patients and prioritizing high specificity. OBJECTIVE: Using tetralogy of Fallot as a model of transmural right ventricular (RV) scar and MRI as reference, we aimed to study the potential influence of contact force (CF) on voltage mapping and to define voltage cutoff values for RV scar. METHODS: Fourteen patients (age 32.6±14.3, 5 female) with repaired tetralogy of Fallot underwent high resolution cardiac MRI (1...
March 20, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Guodong Niu, Tianjie Feng, Chunlan Jiang, Ni Suo, Jinxuan Lin, Fujian Qu, Luke C McSpadden, Yan Yao, Shu Zhang
INTRODUCTION: Radiofrequency catheter ablation is an effective therapy for focal idiopathic outflow tract ventricular arrhythmia (OTVA). However, visual inspection of the unipolar electrogram (EGM) QS morphology is subjective with a poor specificity for predicting successful ablation sites. This study aims to evaluate the predictive value of unipolar and bipolar EGMs in OTVA mapping and ablation. METHODS AND RESULTS: Twenty-two patients scheduled for idiopathic OTVA ablation were prospectively enrolled...
March 23, 2018: Journal of Cardiovascular Electrophysiology
Maciej Kubala, Rajeev K Pathak, Shuanglun Xie, Ruben Casado Arroyo, Cory M Tschabrunn, Tatsuya Hayashi, Fermin C Garcia, Gregory E Supple, Pasquale Santangeli, David S Frankel, Erica S Zado, David J Callans, Francis E Marchlinski
BACKGROUND: Repolarization abnormalities in arrhythmogenic right ventricular (RV) cardiomyopathy and their relationship to ventricular tachycardia substrate are incompletely understood. METHODS AND RESULTS: In 40 patients (29 men, mean age 38 years) with arrhythmogenic RV cardiomyopathy, we compared the extent and location of abnormal T (NegT) waves ≥1 mm in depth (n=32) and downsloping elevated ST segment (n=13), in ≥2 adjacent leads, to area and location of endocardial bipolar (<1...
March 2018: Circulation. Arrhythmia and Electrophysiology
Ying Han, Zhenyu Lu, Zhenguang Du, Qi Luo, Sheng Chen
BACKGROUND AND OBJECTIVE: Bipolar disorder is often mis-diagnosed as unipolar depression in the clinical diagnosis. The main reason is that, different from other diseases, bipolarity is the norm rather than exception in bipolar disorder diagnosis. YinYang bipolar fuzzy set captures bipolarity and has been successfully used to construct a unified inference mathematical modeling method to bipolar disorder clinical diagnosis. Nevertheless, symptoms and their interrelationships are not considered in the existing method, circumventing its ability to describe complexity of bipolar disorder...
May 2018: Computer Methods and Programs in Biomedicine
Fabian Moser, Andreas Rieger, Christian Pönisch, Hans Kottkamp
INTRODUCTION: Box isolation of fibrotic areas (BIFA) is a promising ablation approach for atrial fibrillation (AF) patients. However, complete isolation of fibrotic anteroseptal left atrial area, where Bachmann's bundle is blending into the left atrial myocardium, is very specific and complex. METHODS AND RESULTS: In 34 AF patients with anteroseptal fibrosis, circumferential BIFA was performed in addition to pulmonary vein isolation. In 8/34 patients, complete isolation of the fibrotic area was achieved with BIFA alone...
March 14, 2018: Journal of Cardiovascular Electrophysiology
Laura Martinez-Mateu, Lucia Romero, Ana Ferrer-Albero, Rafael Sebastian, José F Rodríguez Matas, José Jalife, Omer Berenfeld, Javier Saiz
Anatomically based procedures to ablate atrial fibrillation (AF) are often successful in terminating paroxysmal AF. However, the ability to terminate persistent AF remains disappointing. New mechanistic approaches use multiple-electrode basket catheter mapping to localize and target AF drivers in the form of rotors but significant concerns remain about their accuracy. We aimed to evaluate how electrode-endocardium distance, far-field sources and inter-electrode distance affect the accuracy of localizing rotors...
March 2018: PLoS Computational Biology
Shuanglun Xie, Benoit Desjardins, Maciej Kubala, Jackson Liang, Jiandu Yang, Rob J van der Geest, Robert Schaller, Michael Riley, David Callans, Erica Zado, Francis Marchlinski, Saman Nazarian
BACKGROUND: Criteria for identification of anatomic ventricular tachycardia substrates in arrhythmogenic right ventricular cardiomyopathy (ARVC) on late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) are unclear. OBJECTIVE: The purpose of this study was to define (1) the association of regional right ventricular (RV) epicardial voltage amplitude with the distribution of LGE; and (2) appropriate image signal intensity (SI) thresholds for ventricular tachycardia substrate identification in ARVC...
March 2, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Laura R Bear, Peter R Huntjens, Richard Walton, Olivier Bernus, Ruben Coronel, Rémi Dubois
BACKGROUND: Poor identification of electrical dyssynchrony is postulated to be a major factor contributing to the low success rate for cardiac resynchronization therapy. OBJECTIVE: The purpose of this study was to evaluate the sensitivity of body surface mapping and electrocardiographic imaging (ECGi) to detect electrical dyssynchrony noninvasively. METHODS: Langendorff-perfused pig hearts (n = 11) were suspended in a human torso-shaped tank, with left bundle branch block (LBBB) induced through ablation...
March 1, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Victor Bazan, Pasquale Santangeli, Francis E Marchlinski
No abstract text is available yet for this article.
April 2018: Pacing and Clinical Electrophysiology: PACE
Jonathan Chrispin, Ali R Keramati, Fabrizio R Assis, Satish Misra, Tarek Zghaib, Ronald D Berger, Hugh Calkins, Harikrishna Tandri
AIMS: Prior studies identified a relationship between epicardial bipolar and endocardial unipolar voltage. Whether the relationship is valid with smaller multielectrode mapping catheters has not been reported. We explored the association of right ventricular (RV) endocardial unipolar voltage mapping with epicardial bipolar voltage mapping using a multielectrode mapping catheter. METHODS: Electrograms from patients who underwent multielectrode endocardial and epicardial RV electroanatomical mapping during ablation procedures were analyzed...
April 2018: Pacing and Clinical Electrophysiology: PACE
Shohreh Honarbakhsh, Richard J Schilling, Gurpreet Dhillon, Waqas Ullah, Emily Keating, Rui Providencia, Anthony Chow, Mark J Earley, Ross J Hunter
Objectives: This study sought to use a novel panoramic mapping system (CARTOFINDER) to detect and characterize drivers in persistent atrial fibrillation (AF). Background: Mechanisms sustaining persistent AF remain uncertain. Methods: Patients undergoing catheter ablation for persistent AF were included. A 64-pole basket catheter was used to acquire unipolar signals, which were processed by the mapping system to generate wavefront propagation maps...
January 2018: JACC. Clinical Electrophysiology
Michael Ghannam, Hubert Cochet, Pierre Jais, Maxime Sermesant, Smita Patel, Konstantinos C Siontis, Fred Morady, Frank Bogun
BACKGROUND: Myocardial wall thickness (WT) in patients with a prior myocardial infarction has been used to indicate scarring. However, the correlation of WT with sites critical to ventricular tachycardia (VT) has not been previously investigated. The purpose of this study was to correlate electroanatomic mapping data obtained during VT ablation with WT determined by cardiac computed tomography (CT). METHODS AND RESULTS: Cardiac CTs were performed in 15 consecutive patients (mean age 63 ± 10 years, 86% male, left ventricular ejection fraction 27 ± 12%) with a prior infarct referred for VT ablation...
March 2018: Journal of Cardiovascular Electrophysiology
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