Endocardial infarct scar recognition by myocardial electrical impedance is not influenced by changes in cardiac activation sequence

Amorós-Figueras, Gerard; Jorge, Esther; Alonso‐Martín, Concepción; Traver, Daniel; Ballesta, Maria; Bragós, Ramon; Rosell, J.; Cinca, Juan

doi:10.1016/j.hrthm.2017.11.031

Cited by 25 publications

(32 citation statements)

References 18 publications

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“…The catheter has previously been studied in explanted swine tissue, with LI measured at a range of distances to the endocardium, RF powers and durations. 15 In contrast to voltage mapping, changing activation wavefront did not affect impedance data. 9 In a further in vivo swine study, electrogram amplitude, GI and LI were measured in the blood pool and in myocardial tissue locations in the RA, RV, and LV under intracardiac echocardiography (ICE).…”

Section: Discussionmentioning

confidence: 94%

First clinical use of novel ablation catheter incorporating local impedance data

Martin

Gajendragadkar

et al. 2018

Cardiovasc electrophysiol

103

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Section: Discussionmentioning

confidence: 94%

First clinical use of novel ablation catheter incorporating local impedance data

Martin

Gajendragadkar

et al. 2018

Cardiovasc electrophysiol

103

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“…Patients who died during follow‐up had lower baseline values than survivors. This result may reflect a higher percentage of patients with the LV lead located in an ischemic zone since infarct scar showed lower electrical impedance than the normal myocardium 1,9 . Finally, lower signal amplitudes for both right and LV leads were found in patients with death and VA events.…”

Section: Discussionmentioning

confidence: 99%

“…This result may reflect a higher percentage of patients with the LV lead located in an ischemic zone since infarct scar showed lower electrical impedance than the normal myocardium. 1,9 Finally, lower signal amplitudes for both right and LV leads were found in patients with death and VA events. This is not surprising as cytopenia and fibrosis are associated with lower signals and more advanced heart disease.…”

Section: Predictors Of Death and Ventricular Arrhythmiasmentioning

confidence: 96%

“…Beyond technical aspects, several factors may influence these measurements, including properties of the myocardial tissue surrounding the lead electrodes. 1,2 Prior studies suggested an association between temporal changes in some of these parameters and clinical events, such as heart failure functional class changes or cardiac arrhythmias occurrence. [3][4][5] However, it is unknown whether their values at implant could have a clinical relevance as a systematic analysis of association between baseline measurements and clinical outcomes has never been performed.…”

Section: Introductionmentioning

confidence: 99%

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Atrial signal amplitude predicts atrial high‐rate episodes in implantable cardioverter defibrillator patients: Insights from a large database of remote monitoring transmissions

Zecchin

Solimene²,

D’Onofrio

et al. 2020

Journal of Arrhythmia

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Background Parameters measured during implantable cardioverter defibrillator (ICD) implant also depend on bioelectrical properties of the myocardium. We aimed to explore their potential association with clinical outcomes in patients with single/dual‐chamber ICD and cardiac resynchronization therapy defibrillator (CRT‐D). Methods In the framework of the Home Monitoring Expert Alliance, baseline electrical parameters for all implanted leads were compared by the occurrence of all‐cause mortality, adjudicated ventricular arrhythmia (VA), and atrial high‐rate episode lasting ≥24 hours (24 h AHRE). Results In a cohort of 2976 patients (58.1% ICD) with a median follow‐up of 25 months, event rates were 3.1/100 patient‐years for all‐cause mortality, 18.1/100 patient‐years for VA, and 9.3/100 patient‐years for 24 h AHRE. At univariate analysis, baseline shock impedance was consistently lower in groups with events than without, with a 40 Ω cutoff that better identified high‐risk patients. However, at multivariable analysis, the adjusted‐hazard ratios (HRs) lost statistical significance for any endpoint. Baseline atrial sensing amplitude during sinus rhythm was lower in patients with 24 h AHRE than in those without (2.45 [IQR: 1.65‐3.85] vs 3.51 [IQR: 2.37‐4.67] mV, P < .01). The adjusted HR for 24 h AHRE in patients with atrial sensing >1.5 mV vs those with values ≤1.5 mV was 0.52 (95% CI: 0.33‐0.83), P = .006. Conclusions Although lower baseline shock impedance was observed in patients with events, the association lost statistical significance at multivariable analysis. Conversely, low sinus rhythm atrial sensing (≤1.5 mV) measured with standard transvenous leads could identify subjects at high risk of atrial arrhythmia.

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“…In addition, mapping with multi‐electrode catheters yields more data points and better variability in the angle of incidence and in the relationship to the vector of propagation, thereby reducing the individual confounding effects of bipolar voltage amplitude measurements. Finally a recent paper has shown that endocardial catheter measurement of the electrical impedance can identify infarct scar regions and, in contrast to voltage mapping, the impedance data is not affected by changes in cardiac activation sequence.…”

Section: Localization In Sinus Rhythm Of Channels Defined By Fixed Anmentioning

confidence: 99%

Mapping of ventricular tachycardia in patients with ischemic cardiomyopathy: Current approaches and future perspectives

Pandozi

Lavalle

Russo

et al. 2019

Clinical Cardiology

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Despite the technical improvements made in recent years, the overall long‐term success rate of ventricular tachycardia (VT) ablation in patients with ischemic cardiomyopathy remains disappointing. This unsatisfactory situation has persisted even though several approaches to VT substrate ablation allow mapping and ablation of noninducible/nontolerated arrhythmias. The current substrate mapping methods present some shortcomings regarding the accurate definition of the true scar, the modality of detection in sinus rhythm of abnormal electrograms that identify sites of critical channels during VT and the possibility to determine the boundaries of functional re‐entrant circuits during sinus or paced rhythms. In this review, we focus on current and proposed ablation strategies for VT to provide an overview of the potential/real application (and results) of several ablation approaches and future perspectives.

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Endocardial infarct scar recognition by myocardial electrical impedance is not influenced by changes in cardiac activation sequence

Abstract: Endocardial catheter measurement of electrical impedance can identify infarct scar regions, and in contrast to voltage mapping, the impedance data are not affected by changes in cardiac activation sequence.

Cited by 25 publications

References 18 publications

First clinical use of novel ablation catheter incorporating local impedance data

First clinical use of novel ablation catheter incorporating local impedance data

Atrial signal amplitude predicts atrial high‐rate episodes in implantable cardioverter defibrillator patients: Insights from a large database of remote monitoring transmissions

Mapping of ventricular tachycardia in patients with ischemic cardiomyopathy: Current approaches and future perspectives

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