Electrophysiology and Ablation Unit, Bordeaux University Hospital (Centre Hospitalier Universitaire [CHU]), Pessac, France; Institut Hospitalo-Universitaire (IHU), LIRYC, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac- Bordeaux, France; Université Bordeaux, Institut National de la Santé et de la Recherche Médicale U1045, Bordeaux, France; Department of Electrophysiology, Royal Papworth Hospital National Health Service Foundation Trust, Cambridge, United Kingdom.
Electrophysiology and Ablation Unit, Bordeaux University Hospital (Centre Hospitalier Universitaire [CHU]), Pessac, France; Institut Hospitalo-Universitaire (IHU), LIRYC, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac- Bordeaux, France; Université Bordeaux, Institut National de la Santé et de la Recherche Médicale U1045, Bordeaux, France.
JACC Clin Electrophysiol. 2019 Apr;5(4):470-479. doi: 10.1016/j.jacep.2019.01.016. Epub 2019 Mar 27.
This study reports the use of a novel "Lumipoint" algorithm in ventricular tachycardia (VT) ablation.
Automatic mapping systems aid rapid acquisition of activation maps. However, they may annotate farfield rather than nearfield signal in low voltage areas, making maps difficult to interpret. The Lumipoint algorithm analyzes the complete electrogram tracing and therefore includes nearfield signals in its analysis.
Twenty-two patients with ischemic cardiomyopathy and 5 with dilated cardiomyopathy underwent mapping using the ultra-high density Rhythmia system. Lumipoint algorithms were applied retrospectively.
In all left ventricular substrate maps, changing the window of interest to the post-QRS phase automatically identified late potentials. In 25 of 27 left ventricular VT activation maps, a minimum spatial window of interest correctly identified the VT isthmus as seen by the manually annotated map, entrainment, and response to ablation. In 6 maps, the algorithm identified the isthmus where the standard automatically annotated map did not.
The Lumipoint algorithm automatically highlights areas with electrograms having specific characteristics or timings. This can identify late and fractionated potentials and regions that exhibit discontinuous activation, as well as the isthmus of a VT circuit. These features may enhance human interpretation of the electrogram signals during a case, particularly where the circuit lies in partial scar with low amplitude nearfield signals and potentially allow a more targeted ablation strategy.
本研究报告了一种新型“Lumipoint”算法在室性心动过速（VT）消融中的应用。
自动映射系统有助于快速获取激活图。然而，它们可能会注释远场信号而不是低电压区域的近场信号，从而使地图难以解释。Lumipoint 算法分析完整的电图轨迹，因此包括近场信号在其分析中。
22 例缺血性心肌病患者和 5 例扩张型心肌病患者使用超高密度 Rhythmia 系统进行映射。回顾性应用 Lumipoint 算法。
在所有左心室基质地图中，将感兴趣窗口更改为 QRS 波后相位自动识别晚期电位。在 27 个左心室 VT 激活地图中的 25 个中，最小空间感兴趣窗口正确识别了手动注释地图、诱发电位和消融反应所见的 VT 峡部。在 6 个地图中，算法识别了标准自动注释地图未识别的峡部。
Lumipoint 算法自动突出具有特定特征或时间的电图区域。这可以识别晚期和分叶电位以及表现出不连续激活的区域，以及 VT 回路的峡部。这些特征可能会增强在病例中对电图信号的人工解释，特别是在电路位于具有低幅度近场信号的部分疤痕中，并且可能允许更有针对性的消融策略。
