Document Detail


Integrated multimodal-catheter imaging unveils principal relationships among ventricular electrical activity, anatomy, and function.
MedLine Citation:
PMID:  18083892     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Multiple imaging modalities are employed independent of one another while managing complex cardiac arrhythmias. To combine electrical, anatomical, and functional imaging in a single catheter system, we developed a balloon catheter that carried 64 electrodes on its surface and an intracardiac echocardiography (ICE) catheter through a central lumen. The catheter system was inserted, and the balloon was inflated inside the left ventricle (LV) of eight dogs with 6-wk-old infarction, created by occlusion in the left anterior descending coronary artery. Anatomy was constructed by ICE imaging (9 MHz) through the balloon. Single-beat noncontact mapping (NCM) was performed via the multielectrode array to reconstruct unipolar endocardial electrograms during sinus rhythm. Standard contact mapping (CM) of the endocardium was also carried out for reference. Myocardial infarction in anterior LV extending from the middle to apical regions was localized both by ICE and NCM and validated by CM and pathology. The overall difference in the activation times between NCM and CM was 3 +/- 1 ms. Unipolar voltage in infarcted middle anterior LV was smaller than the voltage in normal middle inferior LV both by NCM (11 +/- 4 vs. 16 +/- 3 mV; P = 0.002) and CM (11 +/- 3 vs. 20 +/- 4 mV; P < 0.001). Unipolar voltage was also inversely related to infarct transmurality, both by NCM (r = -0.87; P = 0.005) and CM (r = -0.94; P < 0.001). The infarct area by ICE (7.7 +/- 2.9 cm(2)) was in agreement with CM (bipolar voltage, <1 mV; and area, 7.6 +/- 3.3 cm(2); r = 0.80; P = 0.016). Meanwhile, the voltage threshold that depicted the infarct area by NCM was directly related to the smallest unipolar voltage reconstructed within the infarct (r = 0.96; P < 0.001). In conclusion, combining NCM and ICE imaging in a single catheter system is feasible. The preclinical development of such an integrated system and its evaluation in experimental myocardial infarction demonstrate capabilities for single-beat mapping at multiple sites as well as the online assessment of anatomy and myocardial function.
Authors:
Liyun Rao; Yuesheng Ling; Renjie He; April L Gilbert; Nikolaos G Frangogiannis; Jianwen Wang; Sherif F Nagueh; Dirar S Khoury
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2007-12-14
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  294     ISSN:  0363-6135     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-12     Completed Date:  2008-03-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H1002-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Methodist DeBakey Heart Center, The Methodist Hospital Research Institute, Houston, TX 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Data Interpretation, Statistical
Dogs
Echocardiography
Electrocardiography
Electrophysiology
Endocardium / anatomy & histology,  physiology,  ultrasonography
Heart / anatomy & histology*,  physiology*
Heart Catheterization / instrumentation*
Heart Function Tests
Heart Ventricles
Myocardial Infarction / physiopathology
Tachycardia, Ventricular / physiopathology
Ventricular Function, Left / physiology
Grant Support
ID/Acronym/Agency:
R01-HL-68768/HL/NHLBI NIH HHS; R01-HL-76246/HL/NHLBI NIH HHS

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