Accuracy of cardiac ablation catheter guidance by means of a single equivalent moving dipole inverse algorithm to identify sites of origin of cardiac electrical activation

Abstract

Accuracy of cardiac ablation catheter guidance by means of a single equivalent moving dipole inverse algorithm to identify sites of origin of cardiac electrical activation The MIT Faculty has made this article openly available. Please share how this access benefits you. Your story matters. Citation Lv, Wener et al. "Accuracy of cardiac ablation catheter guidance by means of a single equivalent moving dipole inverse algorithm to identify sites of origin of cardiac electrical activation."

Use of the inverse solution guidance algorithm method for RF ablation catheter guidance

“…In the computational space localization of the catheter tip, the mean reproducibility error of the ISGA method was 0.31 cm, which is similar to the reproducibility error of the localization of the bipolar pacing electrode sutured to the epicardial surface (0.21 cm). 26 This result indicates that the motion of the ablation catheter in the heart did not induce significant additional error to the ISGA guidance procedure. The reliable localization was due to the identification…”

“…In this guidance method, an SEMD model was used to calculate both the locations of the simulated VT origin ("target") and the tip of the ablation catheter in the ventricle. [20][21][22][23][24][25][26][27] Although the SEMD model is a simplified representation of cardiac electrical activity, it is accurate when the cardiac electrical activity is highly localized, such as when an impulse emerges from the site of origin of VT or spreads from the tip of a pacing or ablation catheter. Even though the ISGA method does not take into account detailed anatomical information, variations in tissue conductivity or boundary effect, this method enables accurate catheter guidance since any nonidealities similarly affect both the computed location of the site of origin of the arrhythmia and the ablation catheter tip.…”

“…Recent studies have shown that the location of epicardial electrodes used for simulating arrhythmia could be identified accurately in in-vivo swine models. 25,26,28 In this study, three different types of pacing stimuli were utilized to simulate VT. In Type-1 experiments, an intracardiac pacing lead was fixed in the ventricular wall at the mid-myocardial level and an ablation catheter was moved from a random location to the "target" location using the ISGA system guidance.…”

“…Recently, we introduced the inverse solution guidance algorithm (ISGA) methodology using a Single Equivalent Moving Dipole (SEMD) model of cardiac electrical activity to localize both the exit site of the reentrant circuit and the tip of an RF ablation catheter. [20][21][22][23][24][25][26][27] By analyzing only a few beats of body surface potentials during ventricular arrhythmia, the ISGA method aims to guide an ablation catheter to the site of its origin. Although the SEMD model is a simplified representation of cardiac electrical activity, using multiple ventricular epicardial electrodes of known location in an in vivo swine model, we have shown that it is accurate when cardiac electrical activity is highly localized.…”

“…Although the SEMD model is a simplified representation of cardiac electrical activity, using multiple ventricular epicardial electrodes of known location in an in vivo swine model, we have shown that it is accurate when cardiac electrical activity is highly localized. 25,26,28 The purpose of this study was to investigate the feasibility of using the ISGA method to guide the ablation catheter, similar to a clinical setting. We simulated VT by means of rapid pacing at various rates using three different approaches (a pacing lead fixed in the myocardium, an epicardial mapping catheter, and an intracardiac ablation catheter), at random positions in the swine's ventricle.…”