Real-Time Localization of Ventricular Tachycardia Origin From the 12-Lead Electrocardiogram.
JACC Clin Electrophysiol
; 3(7): 687-699, 2017 07.
Article
en En
| MEDLINE
| ID: mdl-29759537
ABSTRACT
OBJECTIVES:
The aim of this study was to develop rapid computational methods for identifying the site of origin of ventricular activation from the 12-lead electrocardiogram.BACKGROUND:
Catheter ablation of ventricular tachycardia in patients with structural heart disease frequently relies on a substrate-based approach, which may use pace mapping guided by body-surface electrocardiography to identify culprit exit sites.METHODS:
Patients undergoing ablation of scar-related VT (n = 38) had 12-lead electrocardiograms recorded during pacing at left ventricular endocardial sites (n = 1,012) identified on 3-dimensional electroanatomic maps and registered to a generic left ventricular endocardial surface divided into 16 segments and tessellated into 238 triangles; electrocardiographic data were reduced for each lead to 1 variable, consisting of QRS time integral. Two methods for estimating the origin of activation were developed 1) a discrete method, estimating segment of activation origin using template matching; and 2) a continuous method, using population-based multiple linear regression to estimate triangle of activation origin. A variant of the latter method was derived, using patient-specific multiple linear regression.RESULTS:
The optimal QRS time integral included the first 120 ms of the QRS interval. The mean localization error of population-based regressions was 12 ± 8 mm. Patient-specific regressions can achieve localization accuracy better than 5 mm when at least 10 training-set pacing sites are used; this accuracy further increases with each added pacing site.CONCLUSIONS:
Computational intraprocedure methods can automatically identify the segment and site of left ventricular activation using novel algorithms, with accuracy within <10 mm.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Taquicardia Ventricular
/
Electrocardiografía
Tipo de estudio:
Prognostic_studies
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
JACC Clin Electrophysiol
Año:
2017
Tipo del documento:
Article