Oesterlein Tobias, Frisch Daniel, Loewe Axel, Seemann Gunnar, Schmitt Claus, Dössel Olaf, Luik Armin
Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Germany.
Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg · Bad Krozingen, Medical Center, University of Freiburg, 79106 Freiburg, Germany; Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany.
Biomed Res Int. 2016;2016:5340574. doi: 10.1155/2016/5340574. Epub 2016 Dec 13.
Whole-chamber mapping using a 64-pole basket catheter (BC) has become a featured approach for the analysis of excitation patterns during atrial fibrillation. A flexible catheter design avoids perforation but may lead to spline bunching and influence coverage. We aim to quantify the catheter deformation and endocardial coverage in clinical situations and study the effect of catheter size and electrode arrangement using an in silico basket model. Atrial coverage and spline separation were evaluated quantitatively in an ensemble of clinical measurements. A computational model of the BC was implemented including an algorithm to adapt its shape to the atrial anatomy. Two clinically relevant mapping positions in each atrium were assessed in both clinical and simulated data. The simulation environment allowed varying both BC size and electrode arrangement. Results showed that interspline distances of more than 20 mm are common, leading to a coverage of less than 50% of the left atrial (LA) surface. In an ideal in silico scenario with variable catheter designs, a maximum coverage of 65% could be reached. As spline bunching and insufficient coverage can hardly be avoided, this has to be taken into account for interpretation of excitation patterns and development of new panoramic mapping techniques.
使用64极篮状导管（BC）进行全腔内心电图标测已成为分析房颤期间激动模式的一种特色方法。灵活的导管设计可避免穿孔，但可能导致样条束状聚集并影响覆盖范围。我们旨在量化临床情况下导管的变形和心内膜覆盖范围，并使用计算机篮状模型研究导管尺寸和电极排列的影响。在一系列临床测量中对心房覆盖范围和样条间距进行了定量评估。实施了BC的计算模型，包括使其形状适应心房解剖结构的算法。在临床和模拟数据中评估了每个心房的两个临床相关标测位置。模拟环境允许改变BC尺寸和电极排列。结果表明，样条间距超过20毫米很常见，导致左心房（LA）表面覆盖范围小于50%。在具有可变导管设计的理想计算机模拟场景中，最大覆盖范围可达65%。由于样条束状聚集和覆盖不足几乎无法避免，在解释激动模式和开发新的全景标测技术时必须考虑到这一点。
