Dynamic High-density Functional Substrate Mapping Improves Outcomes in Ischaemic Ventricular Tachycardia Ablation: Sense Protocol Functional Substrate Mapping and Other Functional Mapping Techniques

Papageorgiou, Nikolaos S.; Srinivasan, Neil

doi:10.15420/aer.2020.28

Cited by 4 publications

(4 citation statements)

References 45 publications

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“…Therefore, LVAs acquired using GMC could remain unaffected by differences in potential propagation. 10,11 Regarding the third finding, we noted that mapping using a catheter with more electrodes resulted in more points and less LVA according to various previous studies. 8 This is because number of points acquired per heartbeat increases with number of electrodes, and it seems reasonable that total number of points acquired increases using catheters with more electrodes.…”

Section: Characteristicsmentioning

confidence: 54%

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Grid‐mapping catheters versus PentaRay catheters for left atrial mapping on ensite precision mapping system

Saito

Yamashita

Numajiri

et al. 2022

Cardiovasc electrophysiol

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Introduction: Areas displaying reduced bipolar voltage are defined as low-voltage areas (LVAs). Moreover, left atrial (LA) LVAs after pulmonary vein isolation (PVI) have been reported as a predictor of recurrent atrial fibrillation (AF). In this study, we compared grid mapping catheter (GMC) with PentaRay catheter (PC) for LA voltage mapping on Ensite Precision mapping system.Methods: Twenty-six consecutive patients with LVAs and border zone within the LA were enrolled. After achieving PVI, voltage mapping under high right atrial pacing for 600 ms was performed twice using each catheter type (GMC first, PC next).Furthermore, LVA was defined as a region with a bipolar voltage of <0.50, and border zone was defined as a region with a bipolar voltage of <1.0, or <1.5 mV.Results: Compared with PC, using GMC, voltage mapping contained more mapping points (20 242 [15 859, 26 013] vs. 5589 [4088, 7649]; p < .0001), and more mapping points per minute (1428 [1275, 1803] vs. 558 [372, 783]; p < .0001). In addition, LVA and border zone size using GMC was significantly less than that reported using PC: <1.0 mV (5.9 cm 2 [2.9, 20.2] vs. 13.9 cm 2 [6.3, 24.1], p = .018) and <1.5 mV voltage cutoff (10.6 cm 2 [6.6, 27.2] vs. 21.6 cm 2 [12.6, 35.0], p = .005). Conclusion:Bipolar voltage amplitude estimated by GMC was significantly larger than that estimated by PC on Ensite Precision mapping system. GMC may be able to find highly selective identification of LVAs with lower prevalence and smaller LVA and border zone size.

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Section: Characteristicsmentioning

confidence: 54%

“…The GMC selects the highest amplitude bipolar signal among accepted signals within a vicinity of >1 mm 2 . Therefore, LVAs acquired using GMC could remain unaffected by differences in potential propagation 10,11 …”

Section: Discussionmentioning

confidence: 99%

Grid‐mapping catheters versus PentaRay catheters for left atrial mapping on ensite precision mapping system

Saito

Yamashita

Numajiri

et al. 2022

Cardiovasc electrophysiol

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“…This technique may add to the armamentum of the clinical electrophysiologist to complement current methods of substrate mapping. 23 An example is in the detection of slow uniform propagation associated with late activation during sinus rhythm, which is aligned with the VT isthmus long-axis and can be utilized for its localization. The last sinus rhythm activation point is typically in proximity to the VT isthmus entrance.…”

Section: Clinical Correlatesmentioning

confidence: 99%

Role of activation signatures in re‐entrant ventricular tachycardia circuits

Ciaccio,

Saluja,

Peters

et al. 2023

Cardiovasc electrophysiol

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IntroductionDevelopment of a rapid means to verify the ventricular tachycardia (VT) isthmus location from heart surface electrogram recordings would be a helpful tool for the electrophysiologist.MethodMyocardial infarction was induced in 22 canines by left anterior descending coronary artery ligation under general anesthesia. After 3–5 days, VT was inducible via programmed electrical stimulation at the anterior left ventricular epicardial surface. Bipolar VT electrograms were acquired from 196 to 312 recording sites using a multielectrode array. Electrograms were marked for activation time, and activation maps were constructed. The activation signal, or signature, is defined as the cumulative number of recording sites that have activated per millisecond, and it was utilized to segment each circuit into inner and outer circuit pathways, and as an estimate of best ablation lesion location to prevent VT.ResultsVT circuit components were differentiable by activation signals as: inner pathway (mean: 0.30 sites activating/ms) and outer pathway (mean: 2.68 sites activating/ms). These variables were linearly related (p < .001). Activation signal characteristics were dependent in part upon the isthmus exit site. The inner circuit pathway determined by the activation signal overlapped and often extended beyond the activation map isthmus location for each circuit. The best lesion location estimated by the activation signal would likely block an electrical impulse traveling through the isthmus, to prevent VT in all circuits.ConclusionsThe activation signal algorithm, simple to implement for real‐time computer display, approximates the VT isthmus location and shape as determined from activation marking, and best ablation lesion location to prevent reinduction.

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“…It is known that isochronal late activation mapping (ILAM) in the sinus rhythm is used in RFA treatment of atrial and ventricular tachycardias documented but not induced during the electrophysiological study (EPS) [ 3 – 6 ]. In late potential mapping, it was observed that fragmented recordings were prolonged by constant pacing, and it was suggested that these areas may actively participate in tachycardia [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Secret signal delayed mapping in patients with premature ventricular contractions

İçen,

Sivri,

Ardıç

et al. 2024

pwki

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Introduction Mapping and radiofrequency ablation (RFA) of premature ventricular contractions (PVC) that show diurnal changes during the day, and which are rare during 3-D mapping has become very difficult. The most delayed signal mapping in the right ventricular outflow tract (RVOT) with RV apical pacing might be useful in these situations and we called this method Secret Signal Delayed Mapping (SSDM). Aim To compare the classical RFA and SSDM in patients with PVC. Material and methods A total of 60 patients with > 10% PVCs detected in 24-hour rhythm Holter recordings and admitted to the laboratory for RFA, 30 of whom underwent classical ablation according to the local activation time (LAT) and 30 of whom were included in the SSDM group, were included in our study. In patients who did not have enough PVCs during 3-D mapping, a catheter was placed in the right ventricle, and delayed signals after the ventricular electrogram (EGM) were collected by fixed pacing and such patients were included in the SSDM group. Results In all patients, PVC originated from the RVOT. The mean follow-up time of the patients was 10.2 ±1.6 months. Recurrence was detected in 11 (36.6%) patients in the LAT group and 4 (13.3%) patients in the SSDM group. Signal earlyness in LAT mapping was significantly higher in the LAT group ( p < 0.001). In the SSDM group, an average of 128 ±24 delayed signals were collected, the mean delayed signal time was 77.6 ±17.7 ms. In the SSDM group, the average distance between the earliest signal on the LAT and the most delayed signal on the SSDM was 4.8 ±1.2 mm. Conclusions In the treatment of PVCs with RFA, the SSDM method can be used in addition to classical ablation.

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Dynamic High-density Functional Substrate Mapping Improves Outcomes in Ischaemic Ventricular Tachycardia Ablation: Sense Protocol Functional Substrate Mapping and Other Functional Mapping Techniques

Cited by 4 publications

References 45 publications

Grid‐mapping catheters versus PentaRay catheters for left atrial mapping on ensite precision mapping system

Grid‐mapping catheters versus PentaRay catheters for left atrial mapping on ensite precision mapping system

Role of activation signatures in re‐entrant ventricular tachycardia circuits

Secret signal delayed mapping in patients with premature ventricular contractions

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