Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan.
Division of Cardiology, Department of Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan.
J Cardiovasc Electrophysiol. 2022 Jun;33(6):1223-1233. doi: 10.1111/jce.15455. Epub 2022 Mar 25.
Dynamic display of real-time wavefront activation pattern may facilitate the recognition of reentrant circuits, particularly the diastolic path of ventricular tachycardia (VT).
We aimed to evaluate the feasibility of LiveView Dynamic Display for mapping the critical isthmus of scar-related reentrant VT.
Patients with mappable scar-related reentrant VT were selected. The characteristics of the underlying substrates and VT circuits were assessed using HD grid multielectrode catheter. The VT isthmuses were identified based on the activation map, entrainment, and ablation results. The accuracy of the LiveView findings in detecting potential VT isthmus was assessed.
We studied 18 scar-related reentrant VTs in 10 patients (median age: 59.5 years, 100% male) including 6 and 4 patients with ischemic and nonischemic cardiomyopathy, respectively. The median VT cycle length was 426 ms (interquartile range: 386-466 ms). Among 590 regional mapping displays, 92.0% of the VT isthmus sites were identified by LiveView Dynamic Display. The accuracy of LiveView for isthmus identification was 84%, with positive and negative predictive values of 54.8% and 97.8%, respectively. The area with abnormal electrograms was negatively correlated with the accuracy of LiveView Dynamic Display (r = -.506, p = .027). The median time interval to identify a VT isthmus using LiveView was significantly shorter than that using conventional activation maps (50.5 [29.8-120] vs. 219 [157.5-400.8] s, p = .015).
This study demonstrated the feasibility of LiveView Dynamic Display in identifying the critical isthmus of scar-related VT with modest accuracy.
实时波前激活模式的动态显示可能有助于识别折返环，特别是室性心动过速（VT）的舒张期路径。
我们旨在评估 LiveView 动态显示在绘制与瘢痕相关的折返性 VT 的关键峡部的可行性。
选择可标测的与瘢痕相关的折返性 VT 患者。使用 HD 网格多电极导管评估潜在基质和 VT 环的特征。根据激活图、拖带和消融结果确定 VT 峡部。评估 LiveView 发现潜在 VT 峡部的准确性。
我们研究了 10 名患者（中位年龄：59.5 岁，100%为男性）的 18 例与瘢痕相关的折返性 VT，其中 6 例和 4 例分别患有缺血性和非缺血性心肌病。VT 周期长度中位数为 426ms（四分位距：386-466ms）。在 590 个区域标测显示中，92.0%的 VT 峡部部位通过 LiveView 动态显示识别。LiveView 识别峡部的准确性为 84%，阳性预测值和阴性预测值分别为 54.8%和 97.8%。异常电图区域与 LiveView 动态显示的准确性呈负相关（r=-.506，p=0.027）。使用 LiveView 识别 VT 峡部的中位时间间隔明显短于使用常规激活图（50.5[29.8-120]与 219[157.5-400.8]s，p=0.015）。
这项研究表明，LiveView 动态显示在识别与瘢痕相关的 VT 的关键峡部方面具有中等准确性。
