Heart Center Leipzig, Leipzig, Germany.
Clinique Pasteur Toulouse, Toulouse, France.
J Cardiovasc Electrophysiol. 2018 Sep;29(9):1210-1220. doi: 10.1111/jce.13649. Epub 2018 Jun 19.
Advancements in electrophysiology 3-D mapping systems facilitate the broadening scope of electrophysiology study and catheter ablation to treat complex arrhythmias. While electroanatomical mapping systems have default settings available for a variety of mapping parameters, significant operator customization driven by arrhythmia type and experience can occur. However, multicenter comprehensive reporting of customized mapping settings is lacking.
In this prospective, multicenter observational registry, subjects with cardiac arrhythmias underwent electrophysiology study and ablation procedure using the EnSite Precision™ electroanatomical mapping system per standard of care, and associated automated mapping thresholds and procedural characteristics were observed.
Cardiac mapping and ablation was performed in 503 patients (64.4% male, 59.6 ± 13.2 years) for a variety of indications including atrial fibrillation (N = 277), atrial flutter (N = 67), other supraventricular tachycardias (N = 96), and ventricular tachycardia (N = 56). Automated electroanatomical mapping was used to generate 88.2% of all maps, and arrhythmia-specific adjustments of mapping thresholds were utilized to collect electrophysiologically relevant data. The most commonly used thresholds for mapping in AF were Distance (average 2.7 ± 3.5 mm) and Signal-to-Noise Ratio (5.2 ± 1.1), while mapping in VT commonly used Score (88.5 ± 6.5%) and Distance (0.6 ± 0.5 mm). Automated mapping collected and utilized 8.8 times more data than manual mapping without increasing mapping time.
This registry revealed arrhythmia-specific automated mapping settings used to generate electroanatomical maps of multiple cardiac rhythms with higher point density than manual mapping without increasing mapping time. Commonly used mapping threshold settings could serve as an important reference for new automated electroanatomical mapping users or those expanding their usage to new indications and arrhythmias.
电生理三维标测系统的进步促进了电生理研究和导管消融治疗复杂心律失常范围的扩大。虽然电解剖标测系统为各种标测参数提供了默认设置，但根据心律失常类型和经验，可能会进行大量的操作者自定义设置。然而，缺乏针对定制标测设置的多中心综合报告。
在这项前瞻性、多中心观察性注册研究中，患有心脏心律失常的患者按照标准护理使用 EnSite PrecisionTM 电解剖标测系统进行电生理研究和消融手术，观察相关的自动标测阈值和程序特征。
对 503 名患者（64.4%为男性，59.6±13.2 岁）进行了心脏标测和消融，适应证包括心房颤动（N=277）、心房扑动（N=67）、其他室上性心动过速（N=96）和室性心动过速（N=56）。自动电解剖标测用于生成所有地图的 88.2%，并使用心律失常特异性的标测阈值调整来收集与电生理相关的数据。在 AF 中最常用的映射阈值是距离（平均 2.7±3.5mm）和信噪比（5.2±1.1），而在 VT 中常用的映射阈值是评分（88.5±6.5%）和距离（0.6±0.5mm）。与手动映射相比，自动映射收集和利用的数据多 8.8 倍，而映射时间没有增加。
该注册研究揭示了心律失常特异性的自动映射设置，用于生成多个心脏节律的电解剖图，与手动映射相比，点密度更高，而映射时间没有增加。常用的映射阈值设置可以为新的自动电解剖映射用户或那些将其使用扩展到新的适应证和心律失常的用户提供重要参考。
