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Non-invasive Mapping: Minimal Number Of Leads Needed To Obtain A Good Spatial Resolution Is Higher For Atrial Arrhythmias
Session:
Painel 4 -Arritmologia 1
Speaker:
Leonor Parreira
Congress:
CPC 2020
Topic:
C. Arrhythmias and Device Therapy
Theme:
04. Arrhythmias, General
Subtheme:
04.3 Arrhythmias, General – Diagnostic Methods
Session Type:
Posters
FP Number:
---
Authors:
Leonor Parreira; Pedro Lopes Do Carmo; Pedro Adragão; Silvia Nunes; Diogo Cavaco; António Ferreira; Margarita Budanova; Stepan Zubarev; Hugo Marques; Pedro de Araújo Gonçalves
Abstract
<p><strong>Background</strong>: Non-invasive mapping systems (ECGI) has already proven good accuracy for mapping different arrhythmic substrates.</p> <p><strong>Objective</strong>: Assess what is the minimal number of leads needed to obtain a precise mapping when using the ECGI.</p> <p><strong>Methods: </strong>We enrolled 20 patients (12 male, median age 61 (50-67) years) referred to our center for catheter ablation; 14 with premature ventricular contractions (PVCs), and 6 with premature atrial contractions (PACs). Patients underwent pre-procedural ECGI using the AMYCARD system, that uses up to 224 leads. All patients underwent mapping and ablation with the magnetic navigation system Stereotaxis and the Carto system. We analysed the number of recording leads used to construct the ECGI activation map. We then reprocessed the exam, with half the number of electrode bands; only 6 electrode bands (2 anterior, 2 posterior and 1 each side of the torso); and finally, with the standard 12 lead ECG. We evaluated the concordance with Carto and spatial resolution of the ECGI map. An area for the earliest activation site (EAS) ≤ 1.2 cm<sup>2</sup> is accepted as good resolution. Using a ROC curve, we assessed the minimal number of leads necessary to obtain a good spatial resolution.</p> <p><strong>Results:</strong> The median number of surface leads for the initial map was 143 (127-170), which did not differ between PACs or PVCs. The results are presented in the Table. According to the ROC curve the minimal number of electrodes to have a good spatial resolution was 80 for PACs (AUC 0.965) and 60 for PVCs (AUC 0.888).</p> <p><strong>Conclusion: </strong>Reducing the number of leads caused an increase in the area of EAS and a lower concordance rate, that was worse in case of atrial arrhythmias. However, the number of leads needed to achieve a good spatial resolution was much less than the maximal number available.</p> <p> </p>
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