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Characteristics of Scar-Related Ventricular Tachycardia Circuits Using Ultra-High-Density Mapping: A Multi-Center Study

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Characteristics of Scar-Related Ventricular Tachycardia Circuits Using Ultra-High-Density Mapping: A Multi-Center Study. / Martin, Ruairidh; Maury, Philippe; Bisceglia, Caterina; Wong, Tom; Estner, Heidi; Meyer, Christian; Dallet, Corentin; Martin, Claire A; Shi, Rui; Takigawa, Masateru; Rollin, Anne; Frontera, Antonio; Thompson, Nathaniel; Kitamura, Takeshi; Vlachos, Konstantinos; Wolf, Michael; Cheniti, Ghassen; Duchâteau, Josselin; Massoulié, Grégoire; Pambrun, Thomas; Denis, Arnaud; Derval, Nicolas; Hocini, Mélèze; Della Bella, Paolo; Haïssaguerre, Michel; Jaïs, Pierre; Dubois, Rémi; Sacher, Frédéric.

in: CIRC-ARRHYTHMIA ELEC, Jahrgang 11, Nr. 10, e006569, 10.2018.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Martin, R, Maury, P, Bisceglia, C, Wong, T, Estner, H, Meyer, C, Dallet, C, Martin, CA, Shi, R, Takigawa, M, Rollin, A, Frontera, A, Thompson, N, Kitamura, T, Vlachos, K, Wolf, M, Cheniti, G, Duchâteau, J, Massoulié, G, Pambrun, T, Denis, A, Derval, N, Hocini, M, Della Bella, P, Haïssaguerre, M, Jaïs, P, Dubois, R & Sacher, F 2018, 'Characteristics of Scar-Related Ventricular Tachycardia Circuits Using Ultra-High-Density Mapping: A Multi-Center Study', CIRC-ARRHYTHMIA ELEC, Jg. 11, Nr. 10, e006569. https://doi.org/10.1161/CIRCEP.118.006569

APA

Martin, R., Maury, P., Bisceglia, C., Wong, T., Estner, H., Meyer, C., Dallet, C., Martin, C. A., Shi, R., Takigawa, M., Rollin, A., Frontera, A., Thompson, N., Kitamura, T., Vlachos, K., Wolf, M., Cheniti, G., Duchâteau, J., Massoulié, G., ... Sacher, F. (2018). Characteristics of Scar-Related Ventricular Tachycardia Circuits Using Ultra-High-Density Mapping: A Multi-Center Study. CIRC-ARRHYTHMIA ELEC, 11(10), [e006569]. https://doi.org/10.1161/CIRCEP.118.006569

Vancouver

Martin R, Maury P, Bisceglia C, Wong T, Estner H, Meyer C et al. Characteristics of Scar-Related Ventricular Tachycardia Circuits Using Ultra-High-Density Mapping: A Multi-Center Study. CIRC-ARRHYTHMIA ELEC. 2018 Okt;11(10). e006569. https://doi.org/10.1161/CIRCEP.118.006569

Bibtex

@article{ec28a9e79f314061946d5acd900e5732,
title = "Characteristics of Scar-Related Ventricular Tachycardia Circuits Using Ultra-High-Density Mapping: A Multi-Center Study",
abstract = "BACKGROUND: Ventricular tachycardia (VT) with structural heart disease is dependent on reentry within scar regions. We set out to assess the VT circuit in greater detail than has hitherto been possible, using ultra-high-density mapping.METHODS: All ultra-high-density mapping guided VT ablation cases from 6 high-volume European centers were assessed. Maps were analyzed offline to generate activation maps of tachycardia circuits. Topography, conduction velocity, and voltage of the VT circuit were analyzed in complete maps.RESULTS: Thirty-six tachycardias in 31 patients were identified, 29 male and 27 ischemic. VT circuits and isthmuses were complex, 11 were single loop and 25 double loop; 3 had 2 entrances, 5 had 2 exits, and 15 had dead ends of activation. Isthmuses were defined by barriers, which included anatomic obstacles, lines of complete block, and slow conduction (in 27/36 isthmuses). Median conduction velocity was 0.08 m/s in entrance zones, 0.29 m/s in isthmus regions ( P<0.001), and 0.11 m/s in exit regions ( P=0.002). Median local voltage in the isthmus was 0.12 mV during tachycardia and 0.06 mV in paced/sinus rhythm. Two circuits were identifiable in 5 patients. The median timing of activation was 16% of diastole in entrances, 47% in the mid isthmus, and 77% in exits.CONCLUSIONS: VT circuits identified were complex, some of them having multiple entrances, exits, and dead ends. The barriers to conduction in the isthmus seem to be partly functional in 75% of circuits. Conduction velocity in the VT isthmus slowed at isthmus entrances and exits when compared with the mid isthmus. Isthmus voltage is often higher in VT than in sinus or paced rhythms.",
keywords = "Action Potentials, Aged, Catheter Ablation, Cicatrix/diagnosis, Electrophysiologic Techniques, Cardiac, Europe, Female, Heart Rate, Humans, Male, Middle Aged, Myocardial Infarction/complications, Predictive Value of Tests, Risk Factors, Signal Processing, Computer-Assisted, Tachycardia, Ventricular/diagnosis, Time Factors, Treatment Outcome",
author = "Ruairidh Martin and Philippe Maury and Caterina Bisceglia and Tom Wong and Heidi Estner and Christian Meyer and Corentin Dallet and Martin, {Claire A} and Rui Shi and Masateru Takigawa and Anne Rollin and Antonio Frontera and Nathaniel Thompson and Takeshi Kitamura and Konstantinos Vlachos and Michael Wolf and Ghassen Cheniti and Josselin Duch{\^a}teau and Gr{\'e}goire Massouli{\'e} and Thomas Pambrun and Arnaud Denis and Nicolas Derval and M{\'e}l{\`e}ze Hocini and {Della Bella}, Paolo and Michel Ha{\"i}ssaguerre and Pierre Ja{\"i}s and R{\'e}mi Dubois and Fr{\'e}d{\'e}ric Sacher",
year = "2018",
month = oct,
doi = "10.1161/CIRCEP.118.006569",
language = "English",
volume = "11",
journal = "CIRC-ARRHYTHMIA ELEC",
issn = "1941-3149",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

RIS

TY - JOUR

T1 - Characteristics of Scar-Related Ventricular Tachycardia Circuits Using Ultra-High-Density Mapping: A Multi-Center Study

AU - Martin, Ruairidh

AU - Maury, Philippe

AU - Bisceglia, Caterina

AU - Wong, Tom

AU - Estner, Heidi

AU - Meyer, Christian

AU - Dallet, Corentin

AU - Martin, Claire A

AU - Shi, Rui

AU - Takigawa, Masateru

AU - Rollin, Anne

AU - Frontera, Antonio

AU - Thompson, Nathaniel

AU - Kitamura, Takeshi

AU - Vlachos, Konstantinos

AU - Wolf, Michael

AU - Cheniti, Ghassen

AU - Duchâteau, Josselin

AU - Massoulié, Grégoire

AU - Pambrun, Thomas

AU - Denis, Arnaud

AU - Derval, Nicolas

AU - Hocini, Mélèze

AU - Della Bella, Paolo

AU - Haïssaguerre, Michel

AU - Jaïs, Pierre

AU - Dubois, Rémi

AU - Sacher, Frédéric

PY - 2018/10

Y1 - 2018/10

N2 - BACKGROUND: Ventricular tachycardia (VT) with structural heart disease is dependent on reentry within scar regions. We set out to assess the VT circuit in greater detail than has hitherto been possible, using ultra-high-density mapping.METHODS: All ultra-high-density mapping guided VT ablation cases from 6 high-volume European centers were assessed. Maps were analyzed offline to generate activation maps of tachycardia circuits. Topography, conduction velocity, and voltage of the VT circuit were analyzed in complete maps.RESULTS: Thirty-six tachycardias in 31 patients were identified, 29 male and 27 ischemic. VT circuits and isthmuses were complex, 11 were single loop and 25 double loop; 3 had 2 entrances, 5 had 2 exits, and 15 had dead ends of activation. Isthmuses were defined by barriers, which included anatomic obstacles, lines of complete block, and slow conduction (in 27/36 isthmuses). Median conduction velocity was 0.08 m/s in entrance zones, 0.29 m/s in isthmus regions ( P<0.001), and 0.11 m/s in exit regions ( P=0.002). Median local voltage in the isthmus was 0.12 mV during tachycardia and 0.06 mV in paced/sinus rhythm. Two circuits were identifiable in 5 patients. The median timing of activation was 16% of diastole in entrances, 47% in the mid isthmus, and 77% in exits.CONCLUSIONS: VT circuits identified were complex, some of them having multiple entrances, exits, and dead ends. The barriers to conduction in the isthmus seem to be partly functional in 75% of circuits. Conduction velocity in the VT isthmus slowed at isthmus entrances and exits when compared with the mid isthmus. Isthmus voltage is often higher in VT than in sinus or paced rhythms.

AB - BACKGROUND: Ventricular tachycardia (VT) with structural heart disease is dependent on reentry within scar regions. We set out to assess the VT circuit in greater detail than has hitherto been possible, using ultra-high-density mapping.METHODS: All ultra-high-density mapping guided VT ablation cases from 6 high-volume European centers were assessed. Maps were analyzed offline to generate activation maps of tachycardia circuits. Topography, conduction velocity, and voltage of the VT circuit were analyzed in complete maps.RESULTS: Thirty-six tachycardias in 31 patients were identified, 29 male and 27 ischemic. VT circuits and isthmuses were complex, 11 were single loop and 25 double loop; 3 had 2 entrances, 5 had 2 exits, and 15 had dead ends of activation. Isthmuses were defined by barriers, which included anatomic obstacles, lines of complete block, and slow conduction (in 27/36 isthmuses). Median conduction velocity was 0.08 m/s in entrance zones, 0.29 m/s in isthmus regions ( P<0.001), and 0.11 m/s in exit regions ( P=0.002). Median local voltage in the isthmus was 0.12 mV during tachycardia and 0.06 mV in paced/sinus rhythm. Two circuits were identifiable in 5 patients. The median timing of activation was 16% of diastole in entrances, 47% in the mid isthmus, and 77% in exits.CONCLUSIONS: VT circuits identified were complex, some of them having multiple entrances, exits, and dead ends. The barriers to conduction in the isthmus seem to be partly functional in 75% of circuits. Conduction velocity in the VT isthmus slowed at isthmus entrances and exits when compared with the mid isthmus. Isthmus voltage is often higher in VT than in sinus or paced rhythms.

KW - Action Potentials

KW - Aged

KW - Catheter Ablation

KW - Cicatrix/diagnosis

KW - Electrophysiologic Techniques, Cardiac

KW - Europe

KW - Female

KW - Heart Rate

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Infarction/complications

KW - Predictive Value of Tests

KW - Risk Factors

KW - Signal Processing, Computer-Assisted

KW - Tachycardia, Ventricular/diagnosis

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1161/CIRCEP.118.006569

DO - 10.1161/CIRCEP.118.006569

M3 - SCORING: Journal article

C2 - 30354406

VL - 11

JO - CIRC-ARRHYTHMIA ELEC

JF - CIRC-ARRHYTHMIA ELEC

SN - 1941-3149

IS - 10

M1 - e006569

ER -