Document Detail


Comparison of electroanatomic contact and noncontact mapping of ventricular scar in a postinfarct ovine model with intramural needle electrode recording and histological validation.
MedLine Citation:
PMID:  19808431     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Substrate-based ablation is useful for nonhemodynamically tolerated postinfarct ventricular tachycardia. We assessed the accuracy of the CARTO contact and EnSite noncontact systems at identifying scar in a chronic ovine model with intramural plunge needle electrode recording and histological validation. METHODS AND RESULTS: Scar mapping was performed on 8 male sheep with previous percutaneous-induced myocardial infarction. Up to 20 plunge needles were inserted into the left ventricle of each animal in areas of dense scar, scar border, and normal myocardium. A simultaneous CARTO map and EnSite geometry were acquired using a single catheter, and needle electrode locations were registered. A dynamic substrate map was constructed using ratiometric 50% peak negative voltage. The scar percentage around each needle location was quantified histologically. Analysis was performed on 152 plunge needles and corresponding histological blocks. Spearman correlation with histology was 0.690 (P<0.001) for needle electrode peak-to-peak voltage (PPV), 0.362 (P<0.001) and 0.492 (P<0.001) for CARTO bipolar and unipolar PPV, and 0.381 (P<0.001) for EnSite dynamic substrate map (< or =40 mm from array). The area under the receiver operator characteristics curve (<50% and > or =50% scar) was 0.896 for needle electrode PPV, 0.726 and 0.697 for CARTO bipolar and unipolar PPV, and 0.703 for EnSite dynamic substrate map (< or=40 mm from array). CONCLUSIONS: Both the CARTO contact and EnSite noncontact systems were moderately accurate in identifying postinfarct scar when compared with intramural electrodes and confirmed with histology. The EnSite dynamic substrate map was comparable to the CARTO contact bipolar PPV when points >40 mm from the array were excluded.
Authors:
Gopal Sivagangabalan; Jim Pouliopoulos; Kaimin Huang; Juntang Lu; Michael A Barry; Aravinda Thiagalingam; David L Ross; Stuart P Thomas; Pramesh Kovoor
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2008-10-07
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  1     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2009-10-07     Completed Date:  2009-10-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  363-9     Citation Subset:  IM    
Affiliation:
Cardiology Department, Westmead Hospital, Sydney, Australia.
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MeSH Terms
Descriptor/Qualifier:
Animals
Chronic Disease
Cicatrix
Disease Models, Animal
Electrophysiologic Techniques, Cardiac*
Heart Ventricles / pathology,  physiopathology
Male
Myocardial Infarction / complications*,  pathology,  physiopathology
Myocardium / pathology*
ROC Curve
Reproducibility of Results
Sheep
Signal Processing, Computer-Assisted
Tachycardia, Ventricular / etiology*,  pathology,  physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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