학술논문
Multisize Electrode Field-of-View: Validation by High Resolution Gadolinium-Enhanced Cardiac Magnetic Resonance.
Document Type
Academic Journal
Author
Omara S; Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark; Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.; Glashan CA; Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark; Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.; Tofig BJ; Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.; Leenknegt L; Department of Mathematics, KU Leuven campus Kortrijk, Kortrijk, Belgium.; Dierckx H; Department of Mathematics, KU Leuven campus Kortrijk, Kortrijk, Belgium.; Panfilov AV; Department of Physics and Astronomy, Ghent University, Ghent, Belgium.; Beukers HKC; Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.; van Waasbergen MH; Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.; Tao Q; Department of Imaging Physics, Delft University of Technology, Delft, the Netherlands.; Stevenson WG; Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Nielsen JC; Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.; Lukac P; Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.; Kristiansen SB; Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.; van der Geest RJ; Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands.; Zeppenfeld K; Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark; Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: k.zeppenfeld@lumc.nl.
Source
Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101656995 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2405-5018 (Electronic) Linking ISSN: 2405500X NLM ISO Abbreviation: JACC Clin Electrophysiol Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Voltage mapping to detect ventricular scar is important for guiding catheter ablation, but the field-of-view of unipolar, bipolar, conventional, and microelectrodes as it relates to the extent of viable myocardium (VM) is not well defined.
Objectives: The purpose of this study was to evaluate electroanatomic voltage-mapping (EAVM) with different-size electrodes for identifying VM, validated against high-resolution ex-vivo cardiac magnetic resonance (HR-LGE-CMR).
Methods: A total of 9 swine with early-reperfusion myocardial infarction were mapped with the QDOT microcatheter. HR-LGE-CMR (0.3-mm slices) were merged with EAVM. At each EAVM point, the underlying VM in multisize transmural cylinders and spheres was quantified from ex vivo CMR and related to unipolar and bipolar voltages recorded from conventional and microelectrodes.
Results: In each swine, 220 mapping points (Q1, Q3: 216, 260 mapping points) were collected. Infarcts were heterogeneous and nontransmural. Unipolar and bipolar voltage increased with VM volumes from >175 mm3 up to >525 mm 3 (equivalent to a 5-mm radius cylinder with height >6.69 mm). VM volumes in subendocardial cylinders with 1- or 3-mm depth correlated poorly with all voltages. Unipolar voltages recorded with conventional and microelectrodes were similar (difference 0.17 ± 2.66 mV) and correlated best to VM within a sphere of radius 10 and 8 mm, respectively. Distance-weighting did not improve the correlation.
Conclusions: Voltage increases with transmural volume of VM but correlates poorly with small amounts of VM, which limits EAVM in defining heterogeneous scar. Microelectrodes cannot distinguish thin from thick areas of subendocardial VM. The field-of-view for unipolar recordings for microelectrodes and conventional electrodes appears to be 8 to 10 mm, respectively, and unexpectedly similar.
Competing Interests: Funding Support and Author Disclosures This study was partially supported by an investigator-initiated grant from Biosense Webster (a Johnson and Johnson company). Dr Tofig has received research support from the Arvid Nilssons Foundation. Mr Leenknegt was funded by FWO-Flanders grant number G025820N and KU Leuven grant STG/19/007. Outside this work, Dr Nielsen has received research support from the Novo Nordisk Foundation (grants NNF16OC0018658 and NNF17OC0029148). Dr Lukac has received an institutional grant from Abbott Denmark and Biosense Webster. All other authors have reported that they have no relationships to disclose that are relevant to the contents of this paper.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Objectives: The purpose of this study was to evaluate electroanatomic voltage-mapping (EAVM) with different-size electrodes for identifying VM, validated against high-resolution ex-vivo cardiac magnetic resonance (HR-LGE-CMR).
Methods: A total of 9 swine with early-reperfusion myocardial infarction were mapped with the QDOT microcatheter. HR-LGE-CMR (0.3-mm slices) were merged with EAVM. At each EAVM point, the underlying VM in multisize transmural cylinders and spheres was quantified from ex vivo CMR and related to unipolar and bipolar voltages recorded from conventional and microelectrodes.
Results: In each swine, 220 mapping points (Q1, Q3: 216, 260 mapping points) were collected. Infarcts were heterogeneous and nontransmural. Unipolar and bipolar voltage increased with VM volumes from >175 mm
Conclusions: Voltage increases with transmural volume of VM but correlates poorly with small amounts of VM, which limits EAVM in defining heterogeneous scar. Microelectrodes cannot distinguish thin from thick areas of subendocardial VM. The field-of-view for unipolar recordings for microelectrodes and conventional electrodes appears to be 8 to 10 mm, respectively, and unexpectedly similar.
Competing Interests: Funding Support and Author Disclosures This study was partially supported by an investigator-initiated grant from Biosense Webster (a Johnson and Johnson company). Dr Tofig has received research support from the Arvid Nilssons Foundation. Mr Leenknegt was funded by FWO-Flanders grant number G025820N and KU Leuven grant STG/19/007. Outside this work, Dr Nielsen has received research support from the Novo Nordisk Foundation (grants NNF16OC0018658 and NNF17OC0029148). Dr Lukac has received an institutional grant from Abbott Denmark and Biosense Webster. All other authors have reported that they have no relationships to disclose that are relevant to the contents of this paper.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)