Scar voltage threshold determination using ex vivo magnetic resonance imaging integration in a porcine infarct model: Influence of interelectrode distances and three-dimensional spatial effects of scar

Tung, Roderick; Kim, Steve; Daigo, Yataro; Vaseghi, Marmar; Ennis, Daniel B.; Ouadah, Sarah; Ajijola, Olujimi A.; Bradfield, Jason S.; Mahapatra, Srijoy; Finn, Paul; Shivkumar, Kalyanam

doi:10.1016/j.hrthm.2016.07.003

Cited by 46 publications

(42 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, Gianni and Natale also questioned the appropriateness of application of fixed bipolar voltage thresholds to different catheter designs and substrates . It was also recommended from Tung et al's work on bipolar thresholds that such values must be constantly adapted depending on the instruments used for mapping . Hence, we sought to adapt our voltage threshold relative to our mapping instruments and methods.…”

Section: Discussionmentioning

confidence: 99%

Physiological Assessment of Ventricular Myocardial Voltage Using Omnipolar Electrograms

Magtibay

Massé

Asta

et al. 2017

JAHA

View full text Add to dashboard Cite

BackgroundCharacterization of myocardial health by bipolar electrograms are critical for ventricular tachycardia therapy. Dependence of bipolar electrograms on electrode orientation may reduce reliability of voltage assessment along the plane of arrhythmic myocardial substrate. Hence, we sought to evaluate voltage assessment from orientation‐independent omnipolar electrograms.Methods and ResultsWe mapped the ventricular epicardium of 5 isolated hearts from each species—healthy rabbits, healthy pigs, and diseased humans—under paced conditions. We derived bipolar electrograms and voltage peak‐to‐peak (Vpps) along 2 bipolar electrode orientations (horizontal and vertical). We derived omnipolar electrograms and Vpps using omnipolar electrogram methodology. Voltage maps were created for both bipoles and omnipole. Electrode orientation affects the bipolar voltage map with an average absolute difference between horizontal and vertical of 0.25±0.18 mV in humans. Vpps provide larger absolute values than horizontal and vertical bipolar Vpps by 1.6 and 1.4 mV, respectively, in humans. Bipolar electrograms with the largest Vpps from either along horizontal or vertical orientation are highly correlated with omnipolar electrograms and with Vpps values (0.97±0.08 and 0.94±0.08, respectively). Vpps values are more consistent than bipoles, in both beat‐by‐beat (CoV, 0.28±0.19 versus 0.08±0.13 in human hearts) and rhythm changes (0.55±0.21 versus 0.40±0.20 in porcine hearts).ConclusionsOmnipoles provide physiologically relevant and consistent voltages that are along the maximal bipolar direction on the plane of the myocardium.

show abstract

Section: Discussionmentioning

confidence: 99%

Physiological Assessment of Ventricular Myocardial Voltage Using Omnipolar Electrograms

Magtibay

Massé

Asta

et al. 2017

JAHA

View full text Add to dashboard Cite

show abstract

“…7,21 With the implementation of rapid coronary reperfusion therapies, the contemporary cohorts of patients with postinfarction VT have a higher proportion of patchy and heterogeneous rather than transmural scars. 7,13,27,42,43 In contrast, in the setting of NICM transmural scarring is much less common than patchy/layered scarring, which frequently encompasses only the epi. 7,13,27,42,43 In contrast, in the setting of NICM transmural scarring is much less common than patchy/layered scarring, which frequently encompasses only the epi.…”

Section: Usefulness Of Unip Mapping To Define Vt Substrate In Icm Vmentioning

confidence: 99%

“…27,40,42 In this setting, the near-field component of the UNIP EGM may differ in its polarity with respect to a variable number of distant wave fronts, thus substantially decreasing the resulting absolute voltage value. 27,40,42 In this setting, the near-field component of the UNIP EGM may differ in its polarity with respect to a variable number of distant wave fronts, thus substantially decreasing the resulting absolute voltage value.…”

Section: Endocardial Unip Voltage Cutoff Suggesting Epi Scar Withinmentioning

confidence: 99%

“…27,40,42 In this setting, the near-field component of the UNIP EGM may differ in its polarity with respect to a variable number of distant wave fronts, thus substantially decreasing the resulting absolute voltage value. 27,38,39,41,42,46,47 gadolinium enhancement. 27,38,39,41,42,46,47 gadolinium enhancement.…”

Section: Endocardial Unip Voltage Cutoff Suggesting Epi Scar Withinmentioning

confidence: 99%

See 1 more Smart Citation

Three‐dimensional myocardial scar characterization from the endocardium: Usefulness of endocardial unipolar electroanatomic mapping

Bazán

Frankel

García

et al. 2019

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Epicardial ablation may be required to eliminate ventricular tachycardia (VT) in patients with underlying structural heart disease. The decision to gain epicardial access is frequently based on the suspicion of an epicardial origin for the VT and/or presence of an arrhythmogenic substrate. Epicardial pathology and VT is frequently present in patients with nonischemic right and/or left cardiomyopathies even in the setting of modest or no endocardial bipolar voltage substrate. In this setting, unipolar voltage mapping from the endocardium serves to help identify midmyocardial and/or epicardial VT substrate. The additional value of endocardial unipolar mapping includes its usefulness to predict the clinical outcome after VT ablation, to determine the irreversibility of myocardial disease, and to guide endomyocardial biopsy procedures to specific areas of intramural scarring. In this review, we aim to provide a guide to the use of endocardial unipolar mapping and its appropriate interpretation in a variety of clinical situations.

show abstract

“…In recent years, their use in translational research has significantly expanded due to the development of genetically modified and experimentally-induced pig models of human disease. These include cystic fibrosis 19–21 , muscular dystrophy 22 , diabetes 23 , cardiovascular disease 24,2526 , diabetes 27 , cancer 28,29 , environmental toxicology 30 , cutaneous wound healing 31 , metabolic syndrome 32 , among others. Porcine models have also been used to investigate traumatic brain injury 3 , neurodegenerative diseases 33,34 , brain development 35 , seizures 36 , cognition 37 , and neurogenesis 38 .…”

Section: Discussionmentioning

confidence: 99%

Simple and reproducible approaches for the collection of select porcine ganglia

Meyerholz

Reznikov

2017

Journal of Neuroscience Methods

View full text Add to dashboard Cite

Background The anatomy and physiology of the pig nervous system is more similar to humans compared to traditional rodent models. This makes the pig an attractive model to answer questions relating to human health and disease. Yet the technical and molecular tools available to pig researchers are limited compared to rodent researchers New Method We developed simple and rapid methods to isolate the trigeminal, nodose (distal vagal), and dorsal root ganglia from neonatal pigs. We selected these ganglia due to their broad applicability to basic science researchers and clinicians Results Use of these methods resulted in reproducible isolation of all three types of ganglia as validated by histological examination. Comparison with Existing Method(s) There are currently no methods that describe a step-by-step protocol to isolate these porcine ganglia. Conclusions In conclusion, these methods for ganglia collection will facilitate and accelerate future neuroscience investigations in pig models of human disease.

show abstract

Scar voltage threshold determination using ex vivo magnetic resonance imaging integration in a porcine infarct model: Influence of interelectrode distances and three-dimensional spatial effects of scar

Cited by 46 publications

References 28 publications

Physiological Assessment of Ventricular Myocardial Voltage Using Omnipolar Electrograms

Physiological Assessment of Ventricular Myocardial Voltage Using Omnipolar Electrograms

Three‐dimensional myocardial scar characterization from the endocardium: Usefulness of endocardial unipolar electroanatomic mapping

Simple and reproducible approaches for the collection of select porcine ganglia

Contact Info

Product

Resources

About