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Optimization of a Novel Activation-Repolarization Metric to Identify Targets for Catheter Ablation

Campos, FO; Orini, M; Hanson, B; Taggart, P; Lambiase, P; Porter, B; Rinaldi, CA; ... Bishop, MJ; + view all (2018) Optimization of a Novel Activation-Repolarization Metric to Identify Targets for Catheter Ablation. In: Computing in Cardiology 2018. IEEE: Maastricht, The Netherlands.. Green open access

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Abstract

Identification of targets for catheter ablation of arrhythmias remains a significant challenge. We have recently developed a novel substrate mapping procedure, termed the Reentry Vulnerability Index (RVI), which incorporates both activation (AT) and repolarization (RT) times to identify ablation targets. Despite showing promise in a series of experiments, the approach requires further development to enable its incorporation into a clinical protocol. The goal of this study was to use computer simulations to optimize the RVI procedure for its future usage within the clinic. A 2D sheet model was employed to investigate the behavior of the RVI algorithm under mapping catheters recordings resembling clinical conditions. Conduction block following premature stimulation was induced and mapped in a cardiac tissue model including repolarization heterogeneity. RVI maps were computed based on the difference between RTs and ATs between successive pairs of electrodes within a given search radius. A color map was then constructed to highlight small RVI values which identify vulnerable sites for reentry. Within 2D sheet models we show that RVI maps computed on sparse recording sites randomly placed on the tissue surface were in good agreement with high resolution maps. Moreover, RVI maps computed on recording sites resembling a decapolar electrode placed linearly as well as on a fan-like arrangement also captured regions of small RVIs. The RVI algorithm performed well under a wide range of clinicallyrelevant mapping conditions. The RVI metric was capable of identifying pro-arrhythmic regions which may be used to guide ablation.

Type: Proceedings paper
Title: Optimization of a Novel Activation-Repolarization Metric to Identify Targets for Catheter Ablation
Event: Computing in Cardiology 2018
Location: Maastricht, The Netherlands.
Dates: September 23-26, 2018
ISBN-13: 9781728109589
Open access status: An open access version is available from UCL Discovery
DOI: 10.22489/CinC.2018.208
Publisher version: https://doi.org/10.22489/CinC.2018.208
Language: English
Additional information: This is an open-access publication, in which copyright in each article is held by its authors, who grant permission to copy and redistribute their work with attribution, under the terms of the Creative Commons Attribution License https://creativecommons.org/licenses/by/2.5/
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Mechanical Engineering
URI: https://discovery.ucl.ac.uk/id/eprint/10079579
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