Validation of a New Noncontact Catheter System for Electroanatomic Mapping of Left Ventricular Endocardium

Gornick, Charles C.; Adler, Stuart W.; Pederson, Brian; Hauck, John; Budd, Jeffrey R.; Schweitzer, Jeff

doi:10.1161/01.cir.99.6.829

Cited by 148 publications

(120 citation statements)

References 12 publications

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“…Non-contact mapping systems utilize a multi-electrode array (MEA) catheter to simultaneously record endocardial activation over multiple areas [74]. The array is situated on a balloon with 64 electrodes allowing high-density mapping from a single heartbeat.…”

Section: Tissue Characterizationmentioning

confidence: 99%

Optimal site selection and image fusion guidance technology to facilitate cardiac resynchronization therapy

Sieniewicz

Gould

Porter

et al. 2018

Expert Review of Medical Devices

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Introduction: Cardiac resynchronization therapy (CRT) has emerged as one of the few effective treatments for heart failure. However, up to 50% of patients derive no benefit. Suboptimal left ventricle (LV) lead position is a potential cause of poor outcomes while targeted lead deployment has been associated with enhanced response rates. Image-fusion guidance systems represent a novel approach to CRT delivery, allowing physicians to both accurately track and target a specific location during LV lead deployment.Areas covered: This review will provide a comprehensive evaluation of how to define the optimal pacing site. We will evaluate the evidence for delivering targeted LV stimulation at sites displaying favorable viability or advantageous mechanical or electrical properties. Finally, we will evaluate several emerging image-fusion guidance systems which aim to facilitate optimal site selection during CRT.Expert commentary: Targeted LV lead deployment is associated with reductions in morbidity and mortality. Assessment of tissue characterization and electrical latency are critical and can be achieved in a number of ways. Ultimately, the constraints of coronary sinus anatomy have forced the exploration of novel means of delivering CRT including endocardial pacing which hold promise for the future of CRT delivery.

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Section: Tissue Characterizationmentioning

confidence: 99%

Optimal site selection and image fusion guidance technology to facilitate cardiac resynchronization therapy

Sieniewicz

Gould

Porter

et al. 2018

Expert Review of Medical Devices

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“…Simultaneous unipolar AEGs can be collected using high-density NCM [17]. DF analysis of such simultaneous unipolar atrial signals during persAF could help to reveal the spatiotemporal distribution of the atrial activations.…”

Section: Clinical Significancementioning

confidence: 99%

“…Additionally, proper atrial phase mapping can only be achieved with simultaneous atrial recordings [11]. Currently, multi-electrode array (MEA) and baskets provide simultaneous global unipolar AEG measurements [17]. However, there are no commercial solutions for online DF analyses for simultaneous unipolar AEGs.…”

Section: Introductionmentioning

confidence: 99%

An interactive platform to guide catheter ablation in human persistent atrial fibrillation using dominant frequency, organization and phase mapping

Salinet

Almeida

et al. 2017

Computer Methods and Programs in Biomedicine

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“…10,11,14 The system consists of a 64-multielectrode array (MEA) mounted on a 7.5-mL inflatable balloon on a 9F catheter, an amplifier system, and a Silicon Graphics Workstation. For left ventricular study, the MEA was introduced under fluoroscopic guidance from the left femoral artery via the retrograde transaortic route into the ventricle.…”

Section: Noncontact Mappingmentioning

confidence: 99%

“…Previous validation studies were confined to assessment of intracardiac activation, 10,11 and therefore, NCM has not yet been validated as a clinical tool to characterize repolarization changes. In the present study, we compared repolarization timings measured by reconstructed UEs with MAP recordings recorded simultaneously at the same sites in the human left or right ventricle.…”

mentioning

confidence: 99%

Determination of Human Ventricular Repolarization by Noncontact Mapping

et al. 2004

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Background-Noncontact mapping (NCM) has not been validated as a clinical technique to measure ventricular repolarization. We used NCM to determine repolarization characteristics by analysis of reconstructed unipolar electrograms (UEs) at the same sites as monophasic action potential (MAP) recordings in the human ventricle. Methods and Results-MAPs were recorded from a total of 355 beats at 46 sites in the left or right ventricle of 9 patients undergoing ablation of ventricular tachycardia guided by NCM (EnSite system). Measurements were made during sinus rhythm, constant right ventricular pacing, and ventricular extrastimuli during restitution-curve construction. The EnGuide locator signal was used to document MAP catheter locations on the endocardial geometry. UE-determined activation-recovery interval (ARI) measured at the maximum derivative of the T wave (Wyatt method) and the minimum derivative of the positive T wave (alternative method) was correlated with MAP measured at 90% repolarization (MAP90%) at the same sites. ARI correlated with MAP90% during steady state by the Wyatt method (rϭ0.83, PϽ0.001) and the alternative method (rϭ0.94, PϽ0.001). Restitution curves constructed from MAP and UE data exhibited the same characteristics, with a mean correlation coefficient of 0.95 (range, 0.90 to 0.99, PϽ0.001). The error between ARI and MAP90% was greater over a shorter diastolic coupling interval but was not influenced by distance of the sampling site from the multielectrode array. Conclusions-NCM accurately determines steady-state and dynamic endocardial repolarization in humans. Global, high-density, NCM data could be used to characterize abnormalities of human ventricular repolarization. (Circulation.

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Validation of a New Noncontact Catheter System for Electroanatomic Mapping of Left Ventricular Endocardium

Cited by 148 publications

References 12 publications

Optimal site selection and image fusion guidance technology to facilitate cardiac resynchronization therapy

Optimal site selection and image fusion guidance technology to facilitate cardiac resynchronization therapy

An interactive platform to guide catheter ablation in human persistent atrial fibrillation using dominant frequency, organization and phase mapping

Determination of Human Ventricular Repolarization by Noncontact Mapping

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