Automated Ventricular Substrate Mapping—Evaluation in an Ovine Chronic Myocardial Infarction Model

Thiagalingam, Aravinda; Pouliopoulos, Jim; Barry, Michael A.; Boyd, Anita; Eipper, Vicki; Yung, Teresa; Maclean, Fiona; Ross, David L.; Kovoor, Pramesh

doi:10.1111/j.1540-8159.2005.00233.x

Cited by 2 publications

(2 citation statements)

References 25 publications

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“…Similarly, with the use of a commercial noncontact mapping system, early studies showed that determining infarct area by noncontact unipolar voltage mapping was not reliable when a fixed voltage threshold was attempted (22,28). More recent studies have attempted to delineate the infarct area by noncon-tact mapping on the basis of different electrogram characteristics (27) or additional pacing maneuvers in the infarct region (12) with variable results. Studies thus far have focused on determining a voltage threshold in relation to the maximum voltage reconstructed by noncontact mapping.…”

Section: Discussionmentioning

confidence: 99%

Integrated multimodal-catheter imaging unveils principal relationships among ventricular electrical activity, anatomy, and function

Rao

Ling

et al. 2008

American Journal of Physiology-Heart and Circulatory Physiology

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Multiple imaging modalities are employed independent of one another while managing complex cardiac arrhythmias. To combine electrical, anatomical, and functional imaging in a single catheter system, we developed a balloon catheter that carried 64 electrodes on its surface and an intracardiac echocardiography (ICE) catheter through a central lumen. The catheter system was inserted, and the balloon was inflated inside the left ventricle (LV) of eight dogs with 6-wk-old infarction, created by occlusion in the left anterior descending coronary artery. Anatomy was constructed by ICE imaging (9 MHz) through the balloon. Single-beat noncontact mapping (NCM) was performed via the multielectrode array to reconstruct unipolar endocardial electrograms during sinus rhythm. Standard contact mapping (CM) of the endocardium was also carried out for reference. Myocardial infarction in anterior LV extending from the middle to apical regions was localized both by ICE and NCM and validated by CM and pathology. The overall difference in the activation times between NCM and CM was 3 +/- 1 ms. Unipolar voltage in infarcted middle anterior LV was smaller than the voltage in normal middle inferior LV both by NCM (11 +/- 4 vs. 16 +/- 3 mV; P = 0.002) and CM (11 +/- 3 vs. 20 +/- 4 mV; P < 0.001). Unipolar voltage was also inversely related to infarct transmurality, both by NCM (r = -0.87; P = 0.005) and CM (r = -0.94; P < 0.001). The infarct area by ICE (7.7 +/- 2.9 cm(2)) was in agreement with CM (bipolar voltage, <1 mV; and area, 7.6 +/- 3.3 cm(2); r = 0.80; P = 0.016). Meanwhile, the voltage threshold that depicted the infarct area by NCM was directly related to the smallest unipolar voltage reconstructed within the infarct (r = 0.96; P < 0.001). In conclusion, combining NCM and ICE imaging in a single catheter system is feasible. The preclinical development of such an integrated system and its evaluation in experimental myocardial infarction demonstrate capabilities for single-beat mapping at multiple sites as well as the online assessment of anatomy and myocardial function.

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Section: Discussionmentioning

confidence: 99%

Integrated multimodal-catheter imaging unveils principal relationships among ventricular electrical activity, anatomy, and function

Rao

Ling

et al. 2008

American Journal of Physiology-Heart and Circulatory Physiology

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“…21,22 Further work by Thiagalingam enabled incorporation of automated contact mapping with noncontact mapping in the identification of scars. 23 …”

Section: Noncontact Mapping Of Ventricular Tachycardiamentioning

confidence: 97%

Cardiology at Westmead Hospital from 1990 to 2007

Kovoor

2007

Heart, Lung and Circulation

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Automated Ventricular Substrate Mapping—Evaluation in an Ovine Chronic Myocardial Infarction Model

Abstract: ASM enables accurate scar maps to be produced rapidly. This strategy may play an important role for both clinical and research applications, allowing therapeutic agents and radiofrequency ablation to be delivered to critical locations in and around ventricular scar.

Cited by 2 publications

References 25 publications

Integrated multimodal-catheter imaging unveils principal relationships among ventricular electrical activity, anatomy, and function

Integrated multimodal-catheter imaging unveils principal relationships among ventricular electrical activity, anatomy, and function

Cardiology at Westmead Hospital from 1990 to 2007

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