Document Detail


Relationship of specific electrogram characteristics during sinus rhythm and ventricular pacing determined by adaptive template matching to the location of functional reentrant circuits that cause ventricular tachycardia in the infarcted canine heart.
MedLine Citation:
PMID:  10809499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: It would be advantageous, for ablation therapy, to localize reentrant circuits causing ventricular tachycardia by quantifying electrograms obtained during sinus rhythm (SR) or ventricular pacing (VP). In this study, adaptive template matching (ATM) was used to localize reentrant circuits by measuring dynamic electrogram shape using SR and VP data. METHODS AND RESULTS: Four days after coronary occlusion, reentrant ventricular tachycardia was induced in the epicardial border zone of canine hearts by programmed electrical stimulation. Activation maps of circuits were constructed using electrograms recorded from a multichannel array to ascertain block line location. Electrogram recordings obtained during SR/VP then were used for ATM analysis. A template electrogram was matched with electrograms on subsequent cycles by weighting amplitude, vertical shift, duration, and phase lag for optimal overlap. Sites of largest cycle-to-cycle variance in the optimal ATM weights were found to be adjacent to block lines bounding the central isthmus during reentry (mean 61.1% during SR; 63.9% during VP). The distance between the mean center of mass of the ten highest ATM variance peaks and the narrowest isthmus width was determined. For all VP data, the center of mass resided in the isthmus region occurring during reentry. CONCLUSION: ATM high variance measured from SR/VP data localizes functional block lines forming during reentry. The center of mass of the high variance peaks localizes the narrowest width of the isthmus. Therefore, ATM methodology may guide ablation catheter position without resorting to reentry induction.
Authors:
E J Ciaccio; M M Scheinman; A L Wit
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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:  11     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-06-23     Completed Date:  2000-06-23     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  446-57     Citation Subset:  IM    
Affiliation:
Department of Pharmacology, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA. ciaccio@columbia.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardiac Pacing, Artificial* / adverse effects
Diagnosis, Differential
Dogs
Electrophysiology / methods*
Heart Conduction System / physiopathology
Heart Rate / physiology*
Image Processing, Computer-Assisted
Myocardial Infarction / physiopathology*
Tachycardia, Atrioventricular Nodal Reentry / diagnosis*,  etiology,  physiopathology
Grant Support
ID/Acronym/Agency:
HL-30557/HL/NHLBI NIH HHS; R37 HL-31393/HL/NHLBI NIH HHS

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


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