Right ventricular substrate mapping using the Ensite Navx system: Accuracy of high-density voltage map obtained by automatic point acquisition during geometry reconstruction
Articolo
Data di Pubblicazione:
2009
Citazione:
Right ventricular substrate mapping using the Ensite Navx system: Accuracy of high-density voltage map obtained by automatic point acquisition during geometry reconstruction / C. Michela, F. Perna, D.R. Antonio, P. Gemma, S. Bartoletti, R. Annalisa, S. Tommaso, P. Maurizio, F. Giovanni, P. Augusto, D.B. Luigi, N. Luigi, B. Fulvio, Z. Paolo, A. Natale, C. Tondo. - In: HEART RHYTHM. - ISSN 1547-5271. - 6:11(2009), pp. 1598-1605.
Abstract:
Background: Contact point-to-point electroanatomic mapping (Pt-Map) is a validated tool to evaluate right ventricular (RV) substrate. When using the EnSite NavX system (St. Jude Medical, St Paul, Minnesota), geometry reconstruction by dragging the mapping catheter (Geo-Map) allows for quicker acquisition of a large number of points and better definition of anatomy, but it is not validated for substrate mapping. Objective: This study evaluates the feasibility and accuracy of Geo-Map. Methods: Thirteen patients (mean age 38 ± 12 years) with RV arrhythmias and an apparently normal heart underwent cardiac magnetic resonance imaging (MRI), Pt-Map, and Geo-Map. The 2 maps were compared in terms of mapping procedural time, radiation time, and total number of points acquired. We finally compared the number and characteristics of low-potential areas on each patient's Pt-Map, Geo-Map, and cardiac MRI. Results: Geo-Map required significantly shorter mapping and radiation times in comparison to Pt-Map (12.4 ± 4.6 vs. 31.9 ± 10.1 and 5.8 ± 2.1 vs. 12.1 ± 3.9, P <.001). Furthermore, Geo-Map was based on a significantly higher density of points in comparison to Pt-Map (802 ± 205 vs. 194 ± 38, P <.001). Taking into consideration the total number of RV regions analyzed, the Pt-Map and Geo-Map disagreed in 2 of 65 (3%) regions (P = NS), which only Geo-Map identified as low-potential areas and indeed corresponded to wall motion abnormalities on MRI. Conclusion: Voltage maps obtained through RV geometry acquisition have accuracy comparable to that of conventional point-by-point mapping in detecting low-voltage areas, have a good correlation with MRI wall motion abnormalities, and allow a significant reduction in procedural time and x-ray exposure.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Arrhythmogenic right ventricular dysplasia; Cardiac magnetic resonance imaging; Electroanatomic mapping; Adult; Arrhythmias, Cardiac; Body Surface Potential Mapping; Electrophysiologic Techniques, Cardiac; Feasibility Studies; Female; Heart Ventricles; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Cardiology and Cardiovascular Medicine; Physiology (medical)
Elenco autori:
C. Michela, F. Perna, D.R. Antonio, P. Gemma, S. Bartoletti, R. Annalisa, S. Tommaso, P. Maurizio, F. Giovanni, P. Augusto, D.B. Luigi, N. Luigi, B. Fulvio, Z. Paolo, A. Natale, C. Tondo
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