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Non-invasive electrocardiographic mapping using an endo-epicardial system shows better accuracy for atrial arrhythmias than ventricular arrhythmias
Session:
Posters (Sessão 2 - Écran 1) - Arritmias - miscelânea
Speaker:
Leonor Parreira
Congress:
CPC 2023
Topic:
C. Arrhythmias and Device Therapy
Theme:
04. Arrhythmias, General
Subtheme:
04.7 Arrhythmias, General – Other
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Leonor Parreira; Pedro Carmo; Silvia Nunes; Joana Pinho; Stepan Zubarev; Mikhail Chmelevsky; Rita Marinheiro; Lia Marques; Antonio Ferreira; Dinis Mesquita; Duarte Chambel; Pedro Machado; Pedro Amador; Pedro Adragao
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="color:black">Background and aim:</span></span></strong><span style="font-size:10.0pt"><span style="color:black"> Electrocardiographic imaging (ECGI) is capable of performing an activation map with a single beat. The Amycard system (EP Solutions SA, Switzerland) allows for the reconstruction of endo-epicardial potentials both in the ventricles and the atria. The aim of this study was to compare the accuracy of the system to predict the site of origin (SOO) of ventricular focal arrhythmias (VAs) versus atrial focal arrhythmias (AAs). </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="color:black">Methods: </span></span></strong><span style="font-size:10.0pt"><span style="color:black">We studied<strong> </strong>55 consecutive patients referred for ablation of VAs or AAs that had an ECGI performed before ablation. The localization of the VAs and AAs based on the ECGI and invasive electroanatomic mapping was performed using a segmental model of the atria and the ventricles. A perfect match (PM) was defined as a predicted location within the same anatomic segment, whereas a near match (NM) as a predicted location within the same segment or a contiguous one. The number of leads used for ECGI mapping, the agreement between the ECGI and the invasive map, and the success of the procedure were evaluated.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="color:black">Results:</span></span></strong><span style="font-size:10.0pt"><span style="color:black"> Ablation was performed in 49 patients. Patients with AAs were older. We mapped 54 arrhythmias, 37 VAs (37 patients) and 17 AAs (12 patients). The results according to the atrial or ventricular origin of the arrhythmia are depicted in the table. The AMYCARD system correctly identified the SOO of both VAs and AAs in the same segment or a contiguous one in 100% of AAs and 97% of VAs, p=1.000. However, the percentage of a PM (Figure) was higher for AAs than for VAs (100% vs 76%, p=0.044). </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="color:black">Conclusions: </span></span></strong><span style="font-size:10.0pt"><span style="color:black">The endo-epicardial ECGI correctly identified the origin of both ventricular and atrial arrhythmias. However, the accuracy was higher for the latter. </span></span></span></span></p>
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