An efficient algorithm based on electrograms characteristics to identify ventricular tachycardia isthmus entrance in post-infarct patients
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissionsoup.com..
AIMS: Our study assesses the value of electrograms (EGMs) characteristics to identify a ventricular tachycardia (VT) isthmus entrance in patients with post-infarct VT. Post-infarct VTs are mostly due to a re-entrant circuit. A pacemapping (PM) approach is able to localize the VT isthmus during sinus rhythm. Limited data are available about the role of local EGMs in defining VT isthmus location.
METHODS AND RESULTS: Twenty consecutive patients (70% male) referred for post-infarct VT catheter ablation were included in the present study. The VT isthmus was defined according to the PM method. At each recording site, 10 characteristics of the local EGM were assessed to predict the location of the VT isthmus entrance. In total, 924 EGMs were acquired, of which 127 were located in the VT isthmus entrance. Logistic regression analysis showed that bipolar voltage, number of EGM positive peaks, and sQRS interval were independently associated with VT isthmus entrance location. The ROC curve best fitted the model at the cut-off 0.1641 (sensitivity 72%, specificity 75.2%, positive predictive value 31.3%, negative predictive value 94.4%, area under the curve 0.78, P < 0.001). Based upon these results, we developed an algorithm implemented in an automatic calculator to determine the likelihood that an EGM is located at a VT isthmus entrance.
CONCLUSION: Our study suggests that three EGM characteristics: bipolar voltage, number of positive peaks, and sQRS interval can successfully identify a VT isthmus entrance in post-infarct patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
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| Enthalten in: |
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology - 22(2020), 1 vom: 01. Jan., Seite 109-116 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Battaglia, Alberto [VerfasserIn] |
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| Links: |
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| Themen: |
Ablation |
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| Anmerkungen: |
Date Completed 25.06.2021 Date Revised 25.06.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/europace/euz315 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM305089250 |
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| 100 | 1 | |a Battaglia, Alberto |e verfasserin |4 aut | |
| 245 | 1 | 3 | |a An efficient algorithm based on electrograms characteristics to identify ventricular tachycardia isthmus entrance in post-infarct patients |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Revised 25.06.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a AIMS: Our study assesses the value of electrograms (EGMs) characteristics to identify a ventricular tachycardia (VT) isthmus entrance in patients with post-infarct VT. Post-infarct VTs are mostly due to a re-entrant circuit. A pacemapping (PM) approach is able to localize the VT isthmus during sinus rhythm. Limited data are available about the role of local EGMs in defining VT isthmus location | ||
| 520 | |a METHODS AND RESULTS: Twenty consecutive patients (70% male) referred for post-infarct VT catheter ablation were included in the present study. The VT isthmus was defined according to the PM method. At each recording site, 10 characteristics of the local EGM were assessed to predict the location of the VT isthmus entrance. In total, 924 EGMs were acquired, of which 127 were located in the VT isthmus entrance. Logistic regression analysis showed that bipolar voltage, number of EGM positive peaks, and sQRS interval were independently associated with VT isthmus entrance location. The ROC curve best fitted the model at the cut-off 0.1641 (sensitivity 72%, specificity 75.2%, positive predictive value 31.3%, negative predictive value 94.4%, area under the curve 0.78, P < 0.001). Based upon these results, we developed an algorithm implemented in an automatic calculator to determine the likelihood that an EGM is located at a VT isthmus entrance | ||
| 520 | |a CONCLUSION: Our study suggests that three EGM characteristics: bipolar voltage, number of positive peaks, and sQRS interval can successfully identify a VT isthmus entrance in post-infarct patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Ablation | |
| 650 | 4 | |a Ischaemic cardiomyopathy | |
| 650 | 4 | |a Myocardial infarction | |
| 650 | 4 | |a Pacemapping | |
| 650 | 4 | |a Re-entry circuit | |
| 650 | 4 | |a VT isthmus entrance | |
| 650 | 4 | |a Ventricular tachycardia | |
| 700 | 1 | |a Odille, Freddy |e verfasserin |4 aut | |
| 700 | 1 | |a Magnin-Poull, Isabelle |e verfasserin |4 aut | |
| 700 | 1 | |a Sellal, Jean-Marc |e verfasserin |4 aut | |
| 700 | 1 | |a Hoyland, Philip |e verfasserin |4 aut | |
| 700 | 1 | |a Hooks, Darren |e verfasserin |4 aut | |
| 700 | 1 | |a Voilliot, Damien |e verfasserin |4 aut | |
| 700 | 1 | |a Felblinger, Jacques |e verfasserin |4 aut | |
| 700 | 1 | |a de Chillou, Christian |e verfasserin |4 aut | |
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