Use of Novel Electrogram "Lumipoint" Algorithm to Detect Critical Isthmus and Abnormal Potentials for Ablation in Ventricular Tachycardia.
JACC Clin Electrophysiol
; 5(4): 470-479, 2019 04.
Article
em En
| MEDLINE
| ID: mdl-31000101
ABSTRACT
OBJECTIVES:
This study reports the use of a novel "Lumipoint" algorithm in ventricular tachycardia (VT) ablation.BACKGROUND:
Automatic mapping systems aid rapid acquisition of activation maps. However, they may annotate farfield rather than nearfield signal in low voltage areas, making maps difficult to interpret. The Lumipoint algorithm analyzes the complete electrogram tracing and therefore includes nearfield signals in its analysis.METHODS:
Twenty-two patients with ischemic cardiomyopathy and 5 with dilated cardiomyopathy underwent mapping using the ultra-high density Rhythmia system. Lumipoint algorithms were applied retrospectively.RESULTS:
In all left ventricular substrate maps, changing the window of interest to the post-QRS phase automatically identified late potentials. In 25 of 27 left ventricular VT activation maps, a minimum spatial window of interest correctly identified the VT isthmus as seen by the manually annotated map, entrainment, and response to ablation. In 6 maps, the algorithm identified the isthmus where the standard automatically annotated map did not.CONCLUSIONS:
The Lumipoint algorithm automatically highlights areas with electrograms having specific characteristics or timings. This can identify late and fractionated potentials and regions that exhibit discontinuous activation, as well as the isthmus of a VT circuit. These features may enhance human interpretation of the electrogram signals during a case, particularly where the circuit lies in partial scar with low amplitude nearfield signals and potentially allow a more targeted ablation strategy.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Algoritmos
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Taquicardia Ventricular
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Técnicas Eletrofisiológicas Cardíacas
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Ventrículos do Coração
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Aged
/
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
JACC Clin Electrophysiol
Ano de publicação:
2019
Tipo de documento:
Article