Application of Ripple Mapping with an Electroanatomic Mapping System for Diagnosis of Atrial Tachycardias
Application of Ripple Mapping with an Electroanatomic Mapping System for Diagnosis of Atrial Tachycardias
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DOI：
10.1111/jce.12259
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发表时间：
2013-12-01
影响因子：
2.7
通讯作者：
Kanagaratnam, Prapa
中科院分区：
文献类型：
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作者：
Jamil-Copley, Shahnaz;Linton, Nick;Kanagaratnam, Prapa
涟漪映射：背景三维（3D）标测常用于指导房性心动过速（AT）的消融，但标测图易受注释和插值误差的影响。涟漪映射（RM）是一种技术，显示电描记图的时间-电压数据，同时作为动态酒吧的表面shell.ObjectivesWe假设RM将是上级建立3D activation mapping.MethodsCARTO-XPTM地图的AT收集没有任何手动注释和研究基于CARTO的离线RM系统。将成对的未注释CARTO-XP和涟漪标测图提供给接受过有限RM培训的有经验的CARTO用户。这些评估者被允许注释的CARTO-XP地图，但盲目的传统EP data. ResultsCARTO-XP地图AT（10例）进行了研究，在RM格式和诊断证实夹带在所有情况下，终止心动过速9/10例。设盲评估者（n = 11）使用RM在35/44（80%）中达到正确诊断，而使用CARTO-XP在22/44（50%）中达到正确诊断（P = 0.029）。RM的正确诊断时间也更短（136秒vs. 212秒; P = 0.022）。诊断错误的原因，使用RM（点密度不足，特别是在低电压区，和操作员不评估所有可用的视图）被克服了一个改进的MatLab版本，同时显示疤痕和动态酒吧在同一壳.ConclusionRM不需要任何手动注释的本地激活时间，使快速诊断AT具有更高的诊断准确性比传统的3D激活映射。
Ripple Mapping: A Novel 3D EGM DisplayBackgroundThree-dimensional (3D) mapping is often used to guide ablation in atrial tachycardia (AT), but maps can be susceptible to annotation and interpolation errors. Ripple Mapping (RM) is a technique that displays electrogram time-voltage data simultaneously as dynamic bars on the surface shell to overcome these limitations.ObjectivesWe hypothesized that RM would be superior to established 3D activation mapping.MethodsCARTO-XPTM maps of ATs were collected without any manual annotation and studied on a CARTO-based offline RM system. Paired unannotated CARTO-XP and Ripple Maps were presented to experienced CARTO users with limited RM training. These assessors were allowed to annotate the CARTO-XP maps, but were blinded to conventional EP data.ResultsCARTO-XP maps of AT (10 patients) were studied in RM format and the diagnosis was confirmed by entrainment in all cases and with termination of tachycardia in 9/10 cases. Blinded assessors (n = 11) reached the correct diagnosis using RM in 35/44 (80%) compared to 22/44 (50%) using CARTO-XP (P = 0.029). The time to the correct diagnosis was also shorter with RM (136 seconds vs. 212 seconds; P = 0.022). The causes of diagnostic errors using RM (insufficient point density, particularly in low-voltage areas, and the operator not assessing all available views) were overcome with an improved MatLab version showing both scar and dynamic bars on the same shell.ConclusionRM does not need any manual annotation of local activation time and enables rapid diagnosis of AT with higher diagnostic accuracy than conventional 3D activation mapping.