在慢性心肌梗死猪模型中使用多曲线网篮导管进行左心室高分辨率电解剖标测的效用。
Utility of high-resolution electroanatomic mapping of the left ventricle using a multispline basket catheter in a swine model of chronic myocardial infarction.
作者信息
Tanaka Yasuaki, Genet Martin, Chuan Lee Lik, Martin Alastair J, Sievers Richard, Gerstenfeld Edward P
机构信息
Department of Medicine, Section of Cardiac Electrophysiology, University of California, San Francisco, San Francisco, California.
Department of Medicine, Section of Cardiac Electrophysiology, University of California, San Francisco, San Francisco, California.
出版信息
Heart Rhythm. 2015 Jan;12(1):144-54. doi: 10.1016/j.hrthm.2014.08.036. Epub 2014 Aug 27.
BACKGROUND
Standard electroanatomic mapping systems use a single catheter to perform left ventricular substrate mapping. A new mapping system uses a 64-electrode mini-basket catheter to perform rapid automated acquisition of chamber geometry, voltage, and activation.
OBJECTIVE
The aim of this study was to compare the accuracy of electroanatomic mapping using the basket catheter with that of mapping using a standard linear catheter in a swine model of chronic myocardial infarction.
METHODS
Ten swine underwent left anterior descending coronary artery occlusion to create an anteroseptal myocardial infarction. Animals underwent delayed-enhancement magnetic resonance imaging (MRI) and then detailed left ventricular voltage mapping with both the basket and the linear catheter. Map characteristics and scar area were compared between the basket catheter, linear catheter, and MRI. Induced ventricular tachycardia (VT) was mapped with the basket catheter.
RESULTS
More points were acquired with the basket catheter than with the standard catheter (8762 ± 3164 vs 1712 ± 551; P < .001). The fifth percentile of normal bipolar voltage distribution with the basket catheter was 1.54 mV. Using a bipolar voltage cutoff of 1.5 mV, the total infarct areas measured using the basket catheter, linear catheter, and MRI were similar (17.8 cm(2) vs 20.9 cm(2) vs 17.5 cm(2); P = .69); however, the correlation between MRI and catheter scar area measurement was best for the basket catheter (basket vs linear: r = .76 vs r = .71). In 3 animals, sustained poorly tolerated VT was initiated and the circuit mapped successfully with the basket catheter in <5 minutes.
CONCLUSION
Rapid substrate and activation mapping using a 64-electrode mini-basket catheter allows detailed voltage and activation mapping in postinfarction cardiomyopathy. This system may be useful for substrate and VT mapping in human postinfarction cardiomyopathy.
背景
标准的电解剖标测系统使用单根导管进行左心室基质标测。一种新的标测系统使用64极微型篮状导管快速自动获取腔室几何形状、电压和激动情况。
目的
本研究旨在比较在慢性心肌梗死猪模型中，使用篮状导管进行电解剖标测与使用标准线性导管进行标测的准确性。
方法
10头猪接受左前降支冠状动脉闭塞以制造前间隔心肌梗死。动物接受延迟强化磁共振成像（MRI），然后使用篮状导管和线性导管进行详细的左心室电压标测。比较篮状导管、线性导管和MRI之间的标测特征和瘢痕面积。使用篮状导管对诱发的室性心动过速（VT）进行标测。
结果
与标准导管相比，篮状导管采集的点更多（8762±3164对1712±551；P<.001）。篮状导管正常双极电压分布的第5百分位数为1.54 mV。使用1.5 mV的双极电压截断值，使用篮状导管、线性导管和MRI测量的总梗死面积相似（17.8 cm²对20.9 cm²对17.5 cm²；P=.69）；然而，对于篮状导管，MRI与导管瘢痕面积测量之间的相关性最佳（篮状导管对线性导管：r=.76对r=.71）。在3只动物中，诱发了耐受性差的持续性VT，并使用篮状导管在<5分钟内成功标测了折返环路。
结论
使用64极微型篮状导管进行快速基质和激动标测可在心肌梗死后心肌病中进行详细的电压和激动标测。该系统可能对人类心肌梗死后心肌病的基质和VT标测有用。
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