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Characterization of Contact Force During Endocardial and Epicardial Ventricular Mapping.
MedLine Citation:
PMID:  25258362     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -The optimal contact force (CF) for ventricular mapping and ablation remains unvalidated. We assessed CF in different endocardial and epicardial regions during ventricular tachycardia (VT) substrate mapping using a CF-sensing catheter (Smartouch, Biosense-Webster) and compared the trans-septal (TS) versus retro-aortic approach (RAo).
METHODS AND RESULTS: -In total, 8979 mapping points with CF and force vector orientation (VO) were recorded in 21 patients, comprising 13 epicardial, 12 left ventricular (LV) (6 TS, 6 RAo) and 12 right ventricular (RV) endocardial maps. VO was defined as 'adequate' when the vector was directed towards the myocardium. During epicardial mapping, 46% of the points showed an 'adequate' VO and a median CF of 8 (4-13) g, however with significant differences among the 8 regions. When VO was 'inadequate', median CF was higher at 16 (10-24) g (p<0.0001). During LV and RV endocardial mapping, 94% of VO were 'adequate'. Median CF of 'adequate' VO in the LV and RV endocardium were higher than in the epicardium (15 (8-25) and 13 (7-22) g vs. 8 (4-13) g respectively; both p<0.001). Global median LV CF with TS approach was not statistically different from Rao but CF in the apico-inferior and apico-septal regions was higher with TS approach (p<0.001).
CONCLUSIONS: -Ventricular mapping demonstrates important regional variations in CF but in general, CF is higher endocardially than epicardially where poor catheter orientation is associated with higher CF. A TS approach may lead to improved contact particularly in the apico-septal and inferior regions.
Authors:
Laurence Jesel; Frédéric Sacher; Yuki Komatsu; Matthew Daly; Stephan Zellerhoff; Han S Lim; Nicolas Derval; Arnaud Denis; Wislane Ambri; Khaled Ramoul; Valérie Aurillac; Mélèze Hocini; Michel Haïssaguerre; Pierre Jaïs
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-25
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  -     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-26     Completed Date:  -     Revised Date:  2014-9-27    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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