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Mapping the repolarization noninvasively with the epicardial and endocardial mapping system- A validation study
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; Maria Narciso; Pedro Lopes Do Carmo; Silvia Nunes; Joana Pinho; António Ferreira; Pedro de Araújo Gonçalves; Hugo Marques; Margarita Budanova; Stepan Zubarev; Diogo Cavaco; Pedro Adragão
Abstract
<p>Background and aims: The non-invasive endocardial and epicardial electrocardiographic imaging system (ECGI) is capable of displaying an automatic panoramic view of the ventricular repolarization. It is simple and can provide valuable information into the arrhythmia substrate. However, although this method has been extensively validated for the assessment of depolarization, regarding repolarization there is a lack of validation studies. The aim of this study was to validate the measurements obtained with the ECGI by comparison with the ones obtained invasively with the electroanatomical mapping system.</p> <p>Methods: We studied the repolarization pattern in patients that underwent ablation of premature ventricular contractions of the right ventricular outflow tract (RVOT) and performed an ECGI exam before the procedure. The RVOT was divided into 8 segments and the repolarization across the RVOT was measured by the activation recovery interval (ARI), calculated as the difference between the recovery time (RT) and the activation time (AT). The AT was defined as the time of maximal negative slope of the electrogram (EGM) during QRS, and the RT as the time of maximal positive slope of the EGM during T wave. These intervals were automatically obtained with the ECGI and calculated from the extracted invasive unipolar electrograms at the exact same site, using the MATLAB. We assessed the correlation between the measurements obtained with both methods.</p> <p>Results: We assessed the ARI in 64 segments in 8 patients, median age 50 (42-63) years, 4 males. The median absolute value of ARI measured with the ECGI was significantly higher than the ARI assessed from the intracardiac unipolar electrogram, respectively, 332 (320-364) ms and 312 (292-333) ms, p<0.001. However, we found a good correlation between both forms of measurement (R=0.614, p<0.001) (Figure).</p> <p>Conclusions: The automatic measurement of ARI with the ECGI showed a good correlation with the intracardiac measurements.</p>
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