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Combined Ventricular Endocardial and Epicardial Substrate Mapping Using a Sonomicrometry‐Based Electroanatomical Mapping System
Author(s) -
AVILA ANDRE D',
THIAGALINGAM ARAVINDA,
RUSKIN JEREMY N,
REDDY VIVEK Y
Publication year - 2007
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2007.00750.x
Subject(s) - sonomicrometry , medicine , ablation , cardiology , endocardium , radiofrequency ablation , biomedical engineering , hemodynamics
Background:Substrate mapping using a magnetic electroanatomical mapping system (MEAM) has been shown to accurately delineate the location/extent of scarred myocardium. This study examined the ability of a sonomicrometry‐based electroanatomic mapping system (SEAM) to render endocardial and epicardial substrate maps of infarcted ventricular myocardium.Methods and Results:In 7 swine with healed myocardial infarctions, combined epicardial and endocardial left ventricular (LV) substrate maps were created with both SEAM and MEAM mapping systems using 246±68 and 244±44 points respectively. Scarred myocardium was identified based upon bipolar electrogram amplitude < 1.5 mV, and radiofrequency ablation lesions were delivered to the scar border as defined by the sonomicrometry mapping system. The LV endocardial chamber volume as defined by SEAM (125±46 ml) correlated well with that defined by the MEAM (137±45 ml, r=0.77, p < 0.05). The area of infarcted tissue as determined by SEAM was highly correlated with that determined by gross pathology (r=0.96 for endocardial scar and r=0.92 for epicardial scar p < 0.05). The scar area calculated by the SEAM system also correlated well with the scar area determined by the MEAM system (0.91 for endocardial scar and 0.90 for epicardial scar p < 0.05). Finally, the sonomicrometry‐based system was able to guide the placement of radiofrequency ablation lesions to the borders of the scar.Conclusions:This study demonstrates that the sonomicrometry‐based mapping can accurately reconstruct three‐dimensional voltage maps of the endocardial and epicardial ventricular surfaces and guide the placement of ablation lesions along the scar border zone.