Automatic Detection of Slow Conducting Channels during Substrate Ablation of Scar-Related Ventricular Arrhythmias.

Background. Voltage mapping allows identifying the arrhythmogenic substrate during scar-related ventricular arrhythmia (VA) ablation procedures. Slow conducting channels (SCCs), defined by the presence of electrogram (EGM) signals with delayed components (EGM-DC), are responsible for sustaining VAs...

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Autores: Alcaine, Alejandro, Jáuregui, Beatriz, Soto Iglesias, David, Acosta, Juan, Penela, Diego, Fernández Armenta, Juan, Linhart, Markus, Andreu, David, Mont Girbau, Lluís, Laguna, Pablo, Cámara, Óscar, Martínez, Juan Pablo, Berruezo, Antonio
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/195318
Acceso en línea:https://hdl.handle.net/2445/195318
Access Level:acceso abierto
Palabra clave:Arrítmia
Cicatrius
Cirurgia cardíaca
Persones de mitjana edat
Persones grans
Ablació percutània
Arrhythmia
Scars
Heart surgery
Middle aged persons
Older people
Catheter ablation
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spelling Automatic Detection of Slow Conducting Channels during Substrate Ablation of Scar-Related Ventricular Arrhythmias.Alcaine, AlejandroJáuregui, BeatrizSoto Iglesias, DavidAcosta, JuanPenela, DiegoFernández Armenta, JuanLinhart, MarkusAndreu, DavidMont Girbau, LluísLaguna, PabloCámara, ÓscarMartínez, Juan PabloBerruezo, AntonioArrítmiaCicatriusCirurgia cardíacaPersones de mitjana edatPersones gransAblació percutàniaArrhythmiaScarsHeart surgeryMiddle aged personsOlder peopleCatheter ablationBackground. Voltage mapping allows identifying the arrhythmogenic substrate during scar-related ventricular arrhythmia (VA) ablation procedures. Slow conducting channels (SCCs), defined by the presence of electrogram (EGM) signals with delayed components (EGM-DC), are responsible for sustaining VAs and constitute potential ablation targets. However, voltage mapping, as it is currently performed, is time-consuming, requiring a manual analysis of all EGMs to detect SCCs, and its accuracy is limited by electric far-field. We sought to evaluate an algorithm that automatically identifies EGM-DC, classifies mapping points, and creates new voltage maps, named "Slow Conducting Channel Maps" (SCC-Maps). Methods. Retrospective analysis of electroanatomic maps (EAM) from 20 patients (10 ischemic, 10 with arrhythmogenic right ventricular dysplasia/cardiomyopathy) was performed. EAM voltage maps were acquired during sinus rhythm and used for ablation. Preprocedural contrast-enhanced cardiac magnetic resonance (Ce-CMR) imaging was available for the ischemic population. Three mapping modalities were analysed: (i) EAM voltage maps using standard (EAM standard) or manual (EAM screening) thresholds for defining core and border zones; (ii) SCC-Maps derived from the use of the novel SCC-Mapping algorithm that automatically identify EGM-DCs measuring the voltage of the local component; and (iii) Ce-CMR maps (when available). The ability of each mapping modality in identifying SCCs and their agreement was evaluated. Results. SCC-Maps and EAM screening identified a greater number of SCC entrances than EAM standard (3.45 ± 1.61 and 2.95 ± 2.31, resp., vs. 1.05 ± 1.10; ). SCC-Maps and EAM screening highly correlate with Ce-CMR maps in the ischemic population when compared to EAM standard (Lin's correlation = 0.628 and 0.679, resp., vs. 0.212, ). Conclusion. The SCC-Mapping algorithm allows an operator-independent analysis of EGM signals showing better identification of the arrhythmogenic substrate characteristics when compared to standard voltage EAM.Wiley Hindawi Publishing2023202320202023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion13 p.application/pdfhttps://hdl.handle.net/2445/195318Articles publicats en revistes (Medicina)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1155/2020/4386841Journal of Interventional Cardiology, 2020, vol. 2020, num. , p. 4386841https://doi.org/10.1155/2020/4386841cc-by (c) Alcaine, Alejandro et al., 2020https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1953182026-05-29T05:05:01Z
dc.title.none.fl_str_mv Automatic Detection of Slow Conducting Channels during Substrate Ablation of Scar-Related Ventricular Arrhythmias.
title Automatic Detection of Slow Conducting Channels during Substrate Ablation of Scar-Related Ventricular Arrhythmias.
spellingShingle Automatic Detection of Slow Conducting Channels during Substrate Ablation of Scar-Related Ventricular Arrhythmias.
Alcaine, Alejandro
Arrítmia
Cicatrius
Cirurgia cardíaca
Persones de mitjana edat
Persones grans
Ablació percutània
Arrhythmia
Scars
Heart surgery
Middle aged persons
Older people
Catheter ablation
title_short Automatic Detection of Slow Conducting Channels during Substrate Ablation of Scar-Related Ventricular Arrhythmias.
title_full Automatic Detection of Slow Conducting Channels during Substrate Ablation of Scar-Related Ventricular Arrhythmias.
title_fullStr Automatic Detection of Slow Conducting Channels during Substrate Ablation of Scar-Related Ventricular Arrhythmias.
title_full_unstemmed Automatic Detection of Slow Conducting Channels during Substrate Ablation of Scar-Related Ventricular Arrhythmias.
title_sort Automatic Detection of Slow Conducting Channels during Substrate Ablation of Scar-Related Ventricular Arrhythmias.
dc.creator.none.fl_str_mv Alcaine, Alejandro
Jáuregui, Beatriz
Soto Iglesias, David
Acosta, Juan
Penela, Diego
Fernández Armenta, Juan
Linhart, Markus
Andreu, David
Mont Girbau, Lluís
Laguna, Pablo
Cámara, Óscar
Martínez, Juan Pablo
Berruezo, Antonio
author Alcaine, Alejandro
author_facet Alcaine, Alejandro
Jáuregui, Beatriz
Soto Iglesias, David
Acosta, Juan
Penela, Diego
Fernández Armenta, Juan
Linhart, Markus
Andreu, David
Mont Girbau, Lluís
Laguna, Pablo
Cámara, Óscar
Martínez, Juan Pablo
Berruezo, Antonio
author_role author
author2 Jáuregui, Beatriz
Soto Iglesias, David
Acosta, Juan
Penela, Diego
Fernández Armenta, Juan
Linhart, Markus
Andreu, David
Mont Girbau, Lluís
Laguna, Pablo
Cámara, Óscar
Martínez, Juan Pablo
Berruezo, Antonio
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Arrítmia
Cicatrius
Cirurgia cardíaca
Persones de mitjana edat
Persones grans
Ablació percutània
Arrhythmia
Scars
Heart surgery
Middle aged persons
Older people
Catheter ablation
topic Arrítmia
Cicatrius
Cirurgia cardíaca
Persones de mitjana edat
Persones grans
Ablació percutània
Arrhythmia
Scars
Heart surgery
Middle aged persons
Older people
Catheter ablation
description Background. Voltage mapping allows identifying the arrhythmogenic substrate during scar-related ventricular arrhythmia (VA) ablation procedures. Slow conducting channels (SCCs), defined by the presence of electrogram (EGM) signals with delayed components (EGM-DC), are responsible for sustaining VAs and constitute potential ablation targets. However, voltage mapping, as it is currently performed, is time-consuming, requiring a manual analysis of all EGMs to detect SCCs, and its accuracy is limited by electric far-field. We sought to evaluate an algorithm that automatically identifies EGM-DC, classifies mapping points, and creates new voltage maps, named "Slow Conducting Channel Maps" (SCC-Maps). Methods. Retrospective analysis of electroanatomic maps (EAM) from 20 patients (10 ischemic, 10 with arrhythmogenic right ventricular dysplasia/cardiomyopathy) was performed. EAM voltage maps were acquired during sinus rhythm and used for ablation. Preprocedural contrast-enhanced cardiac magnetic resonance (Ce-CMR) imaging was available for the ischemic population. Three mapping modalities were analysed: (i) EAM voltage maps using standard (EAM standard) or manual (EAM screening) thresholds for defining core and border zones; (ii) SCC-Maps derived from the use of the novel SCC-Mapping algorithm that automatically identify EGM-DCs measuring the voltage of the local component; and (iii) Ce-CMR maps (when available). The ability of each mapping modality in identifying SCCs and their agreement was evaluated. Results. SCC-Maps and EAM screening identified a greater number of SCC entrances than EAM standard (3.45 ± 1.61 and 2.95 ± 2.31, resp., vs. 1.05 ± 1.10; ). SCC-Maps and EAM screening highly correlate with Ce-CMR maps in the ischemic population when compared to EAM standard (Lin's correlation = 0.628 and 0.679, resp., vs. 0.212, ). Conclusion. The SCC-Mapping algorithm allows an operator-independent analysis of EGM signals showing better identification of the arrhythmogenic substrate characteristics when compared to standard voltage EAM.
publishDate 2020
dc.date.none.fl_str_mv 2020
2023
2023
2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/195318
url https://hdl.handle.net/2445/195318
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1155/2020/4386841
Journal of Interventional Cardiology, 2020, vol. 2020, num. , p. 4386841
https://doi.org/10.1155/2020/4386841
dc.rights.none.fl_str_mv cc-by (c) Alcaine, Alejandro et al., 2020
https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Alcaine, Alejandro et al., 2020
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 13 p.
application/pdf
dc.publisher.none.fl_str_mv Wiley Hindawi Publishing
publisher.none.fl_str_mv Wiley Hindawi Publishing
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869419308047663104
score 15,81155

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