Document Detail


Endocardial mapping of electrophysiologically abnormal substrates and cardiac arrhythmias using a noncontact nonexpandable catheter.
MedLine Citation:
PMID:  12380927     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: In previous studies, we established methodology for reconstructing endocardial potential maps, electrograms, and isochrones from a noncontact intracavitary catheter during a single beat. Recently, we evaluated this approach using a 9-French (3-mm) spiral catheter in a normal heart preparation. Here we extend the approach to hearts with structural disease and examine its ability to detect and characterize abnormal electrophysiologic (EP) substrates and to map ventricular arrhythmias on a beat-by-beat basis.
METHODS AND RESULTS: Reconstruction of endocardial potentials from cavity potentials measured with 82 electrodes mounted on a 9-French spiral catheter was performed in an isolated canine left ventricle (LV). Endocardial potentials were recorded with 91 intramural needles, providing a gold standard for evaluating the noncontact reconstruction. Studies were performed in a normal LV (control) and the same LV 3 hours after left anterior descending coronary artery occlusion and ethanol injection to create an infarct. Abnormal EP characteristics over the infarct were faithfully reconstructed, including (1) low potentials and electrogram derivatives; (2) fractionated electrograms; (3) small deflections on electrograms reflecting local activation; and (4) slow discontinuous conduction transverse to fibers. During arrhythmia, beat-to-beat dynamic shifts of initiation site and activation pattern were captured by the reconstruction.
CONCLUSION: Noncontact, nonexpendable catheter mapping can locate and characterize abnormal EP substrates and can capture the endocardial sequence of an arrhythmia during a single beat.
Authors:
Ping Jia; Bonnie Punske; Bruno Taccardi; Yoram Rudy
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  13     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-10-16     Completed Date:  2003-02-12     Revised Date:  2014-09-22    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  888-95     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Arrhythmias, Cardiac / diagnosis*,  therapy
Body Surface Potential Mapping / instrumentation*
Cardiac Pacing, Artificial
Catheterization*
Disease Models, Animal
Dogs
Electrophysiologic Techniques, Cardiac / instrumentation*
Endocardium / pathology*,  surgery*
Equipment Design
Equipment Safety
Heart Conduction System / pathology,  surgery
Heart Septum / pathology,  surgery
Heart Ventricles / pathology,  surgery
Models, Cardiovascular
Myocardial Infarction / diagnosis,  therapy
Grant Support
ID/Acronym/Agency:
R01 HL-43276/HL/NHLBI NIH HHS; R01 HL-49054/HL/NHLBI NIH HHS; R37 HL-33343/HL/NHLBI NIH HHS; R37 HL033343/HL/NHLBI NIH HHS; R37 HL033343-18/HL/NHLBI NIH HHS
Comments/Corrections

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