Orini, M;
Hanson, B;
Taggart, P;
Campos, F;
Rinaldi, A;
Gill, J;
Bishop, M;
(2018)
Sequential Electro-Anatomical Mapping Methodology and Preliminary Results for Reentry Vulnerability Index Estimation.
In:
Computing in Cardiology 2018.
IEEE: Maastricht, Netherlands.
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Abstract
Ventricular tachycardia (VT) recurrence after catheter ablation remains frequent and improved ablation strategies are needed. The re-entry vulnerability index (RVI) is an activation-repolarization marker to localize critical sites for VT initiation. Its use is limited since current electro-anatomical mapping systems (EAMS) cannot provide global measurement of activation and repolarization times within a single beat. We carried out a simulation study to assess a simple method to measure RVI using data collected by sequential EAMS and we investigated the effect of background noise, RT variability (σRT ) and ectopics on RVI estimation. The mean correlation coefficient between single ECG beats and a representative template is used as inclusion/exclusion criterion. Localization of the vulnerable region associated with 5% bottom RVI was accurate (sensitivity80±8%, specificity> 99±1%) for moderate to large repolarization variability (5 ≤ σRT ≤ 20 ms) and moderate level of noise (SNR ≥ 10 dB) but it deteriorated for σRT ≥ 25 ms and SNR ≤ 5 dB. Sensitivity remained high even when RVI estimates were only moderately accurate (cc > 0.67 ± 0.05, MAE < 25 ± 1 ms). The number of ectopic beats did not affect the results. In the in-vivo case analyzed, the sites of low RVI and VT exit was close (5.1 mm)
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