Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Monaci, S; Strocchi, M; Rodero, C; Gillette, K; Whitaker, J; Rajani, R; Rinaldi, CA; O'Neill, M; Plank, G; King, A; Bishop, MJ.
In-silico pace-mapping using a detailed whole torso model and implanted electronic device electrograms for more efficient ablation planning.
Comput Biol Med. 2020; 125:104005
Doi: 10.1016/j.compbiomed.2020.104005
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- Co-Autor*innen der Med Uni Graz
- Gillette Karli
- Plank Gernot
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- Abstract:
- BACKGROUND: Pace-mapping is a commonly used electrophysiological (EP) procedure which aims to identify exit sites of ventricular tachycardia (VT) by matching ventricular activation patterns (assessed by QRS morphology) at specific pacing locations with activation during VT. However, long procedure durations and the need for VT induction render this technique non-optimal. To demonstrate the potential of in-silico pace-mapping, using stored electrogram (EGM) recordings of clinical VT from implanted devices to guide pre-procedural ablation planning. METHOD: Six scar-related VT episodes were simulated in a 3D torso model reconstructed from computed tomography (CT) imaging data, including three different infarct anatomies mapped from infarcted porcine imaging data. In-silico pace-mapping was performed to localise VT exit sites and isthmuses by using 12-lead electrocardiogram (ECG) signals and different combinations of EGM sensing vectors from implanted devices, through the creation of conventional correlation maps and reference-less maps. RESULTS: Our in-silico platform was successful in identifying VT exit sites for a variety of different VT morphologies from both ECG correlation maps and corresponding EGM maps, with the latter dependent upon the number of sensing vectors used. We also showed the added utility of both ECG and EGM reference-less pace-mapping for the identification of slow-conducting isthmuses, uncovering the optimal algorithm parameters. Finally, EGM-based pace-mapping was shown to be more dependent upon the mapped surface (epicardial/endocardial), relative to the VT origin. CONCLUSIONS: In-silico pace-mapping can be used along with EGMs from implanted devices to localise VT ablation targets in pre-procedural planning.
- Find related publications in this database (using NLM MeSH Indexing)
- Animals - administration & dosage
- Catheter Ablation - administration & dosage
- Electrocardiography - administration & dosage
- Electronics - administration & dosage
- Swine - administration & dosage
- Tachycardia, Ventricular - diagnostic imaging, surgery
- Torso - administration & dosage
- Find related publications in this database (Keywords)
- Ventricular tachycardia
- Radiofrequency ablation
- Pace-mapping
- 3D torso model
- Ventricular tachycardia exit sites
- Isthmuses