Automatic activation mapping and origin identification of idiopathic outflow tract ventricular arrhythmias

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• dc.contributor.author Alcaine, Alejandro
• dc.contributor.author Soto-Iglesias, David
• dc.contributor.author Acosta, Juan Carlos
• dc.contributor.author Korshunov, Viatcheslav
• dc.contributor.author Penela, Diego
• dc.contributor.author Martínez, Mikel
• dc.contributor.author Linhart, Markus
• dc.contributor.author Andreu Martínez, David
• dc.contributor.author Fernández-Armenta, Juan
• dc.contributor.author Laguna, Pablo
• dc.contributor.author Martínez, Juan Pablo
• dc.contributor.author Camara, Oscar
• dc.contributor.author Berruezo Sánchez, Antonio
• dc.date.accessioned 2021-06-15T10:18:51Z
• dc.date.available 2021-06-15T10:18:51Z
• dc.date.issued 2018
• dc.description.abstract Purpose: Activation mapping is used to guide ablation of idiopathic outflow tract ventricular arrhythmias (OTVAs). Isochronal activation maps help to predict the site of origin (SOO): left vs right outflow tract (OT). We evaluate an algorithm for automatic activation mapping based on the onset of the bipolar electrogram (EGM) signal for predicting the SOO and the effective ablation site in OTVAs. Methods: Eighteen patients undergoing ablation due to idiopathic OTVAs were studied (12 with left ventricle OT origin). Right ventricle activation maps were obtained offline with an automatic algorithm and compared with manual annotation maps obtained during the intervention. Local activation time (LAT) accuracy was assessed, as well as the performance of the 10 ms earliest activation site (EAS) isochronal area in predicting the SOO. Results: High correlation was observed between manual and automatic LATs (Spearman's: 0.86 and Lin's: 0.85, both p < 0.01). The EAS isochronal area were closely located in both map modalities (5.55 ± 3.56 mm) and at a similar distance from the effective ablation site (0.15 ± 2.08 mm difference, p = 0.859). The 10 ms isochronal area longitudinal/perpendicular diameter ratio measured from automatic maps showed slightly superior SOO identification (67% sensitivity, 100% specificity) compared with manual maps (67% sensitivity, 83% specificity). Conclusions: Automatic activation mapping based on the bipolar EGM onset allows fast, accurate and observer-independent identification of the SOO and characterization of the spreading of the activation wavefront in OTVAs.
• dc.description.sponsorship This study was supported by personal grants to A.A. refs.: BES-2011-046644 and EEBB-I-15-09466, by projects TEC2013-42140-R, DPI2016-75458-R and TIN2011-28067 from Ministerio de Economía y Competitividad. Also by Gobierno de Aragón (Spain) and European Social Fund (EU) through Grupo Consolidado BSICoS ref.: T 96. The CIBER-BBN is an initiative of Instituto de Salud Carlos III. This work was also supported in part by the project PI14/00759, integrated in the Plan Nacional de I + D + i and co-funded by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER).
• dc.format.mimetype application/pdf
• dc.identifier.citation Alcaine A, Soto-Iglesias D, Acosta J, Korshunov V, Penela D, Martínez M, Linhart M, Andreu D, Fernández-Armenta J, Laguna P, Martínez JP, Camara O, Berruezo A. Automatic activation mapping and origin identification of idiopathic outflow tract ventricular arrhythmias. J Electrocardiol. 2018;51(2):239-46. DOI: 10.1016/j.jelectrocard.2017.10.015
• dc.identifier.doi http://dx.doi.org/10.1016/j.jelectrocard.2017.10.015
• dc.identifier.issn 0022-0736
• dc.identifier.uri http://hdl.handle.net/10230/47885
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Journal of Electrocardiology. 2018;51(2):239-46.
• dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/TEC2013-42140-R
• dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/DPI2016-75458-R
• dc.relation.projectID info:eu-repo/grantAgreement/ES/3PN/TIN2011-28067
• dc.rights © Elsevier http://dx.doi.org/10.1016/j.jelectrocard.2017.10.015
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword Activation mapping
• dc.subject.keyword Idiopathic ventricular arrhythmia
• dc.subject.keyword Left ventricle outflow tract
• dc.subject.keyword Right ventricle outflow tract
• dc.subject.keyword Ventricular tachycardia ablation
• dc.title Automatic activation mapping and origin identification of idiopathic outflow tract ventricular arrhythmias
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion