New Imaging Technologies To Characterize Arrhythmic Substrate

Overview

Journal J Atr Fibrillation

Date 2016 Dec 14

PMID 27957131

Authors

Antonio Dello Russo

Sergio Conti

Ghaliah Al-Mohani

Michela Casella

Francesca Pizzamiglio

Corrado Carbucicchio

Stefania Riva

Gaetano Fassini

Massimo Moltrasio

Fabrizio Tundo

Martina Zucchetti

Benedetta Majocchi

Eleonora Russo

Vittoria Marino

Fabrizio Bologna

Luigi Di Biase

Andrea Natale

Claudio Tondo

Affiliations

Soon will be listed here.

Abstract

The cornerstone of the new imaging technologies to treat complex arrhythmias is the electroanatomic (EAM) mapping. It is based on tissue characterization and in particular on determination of low potential region and dense scar definition. Recently, the identification of fractionated isolated late potentials increased the specificity of the information derived from EAM. In addition, non-invasive tools and their integration with EAM, such as cardiac magnetic resonance imaging and computed tomography scanning, have been shown to be helpful to characterize the arrhythmic substrate and to guide the mapping and the ablation. Finally, intracardiac echocardiography, known to be useful for several practical uses in the setting of electrophysiological procedures, it has been also demonstrated to provide important informations about the anatomical substrate and may have potential to identify areas of scarred myocardium.

References

Tandri H, Asimaki A, Abraham T, Dalal D, Tops L, Jain R . Prolonged RV endocardial activation duration: a novel marker of arrhythmogenic right ventricular dysplasia/cardiomyopathy. Heart Rhythm. 2009; 6(6):769-75. PMC: 2778730. DOI: 10.1016/j.hrthm.2009.02.031. View

Hutchinson M, Gerstenfeld E, Desjardins B, Bala R, Riley M, Garcia F . Endocardial unipolar voltage mapping to detect epicardial ventricular tachycardia substrate in patients with nonischemic left ventricular cardiomyopathy. Circ Arrhythm Electrophysiol. 2010; 4(1):49-55. PMC: 3041847. DOI: 10.1161/CIRCEP.110.959957. View

McGann C, Kholmovski E, Oakes R, Blauer J, Daccarett M, Segerson N . New magnetic resonance imaging-based method for defining the extent of left atrial wall injury after the ablation of atrial fibrillation. J Am Coll Cardiol. 2008; 52(15):1263-71. DOI: 10.1016/j.jacc.2008.05.062. View

Nakahara S, Tung R, Ramirez R, Michowitz Y, Vaseghi M, Buch E . Characterization of the arrhythmogenic substrate in ischemic and nonischemic cardiomyopathy implications for catheter ablation of hemodynamically unstable ventricular tachycardia. J Am Coll Cardiol. 2010; 55(21):2355-65. PMC: 2896717. DOI: 10.1016/j.jacc.2010.01.041. View

Verma A, Marrouche N, Natale A . Pulmonary vein antrum isolation: intracardiac echocardiography-guided technique. J Cardiovasc Electrophysiol. 2004; 15(11):1335-40. DOI: 10.1046/j.1540-8167.2004.04428.x. View

Hundley W, Bluemke D, Finn J, Flamm S, Fogel M, Friedrich M . ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. J Am Coll Cardiol. 2010; 55(23):2614-62. PMC: 3042771. DOI: 10.1016/j.jacc.2009.11.011. View

Han R, Black A, Culshaw G, French A, Corcoran B . Structural and cellular changes in canine myxomatous mitral valve disease: an image analysis study. J Heart Valve Dis. 2010; 19(1):60-70. View

Calkins H, Kuck K, Cappato R, Brugada J, Camm A, Chen S . 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial.... Heart Rhythm. 2012; 9(4):632-696.e21. DOI: 10.1016/j.hrthm.2011.12.016. View

Bruce C, Packer D, Belohlavek M, Seward J . Intracardiac echocardiography: newest technology. J Am Soc Echocardiogr. 2000; 13(8):788-95. DOI: 10.1067/mje.2000.105463. View

10.

Marcus F, McKenna W, Sherrill D, Basso C, Bauce B, Bluemke D . Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the task force criteria. Circulation. 2010; 121(13):1533-41. PMC: 2860804. DOI: 10.1161/CIRCULATIONAHA.108.840827. View

11.

Efremidis M, Prappa E, Charalampous C, Protonotarios N, Letsas K, Sideris A . Endocardial late potentials during sinus rhythm define the re-entry circuit of ventricular tachycardia in arrhythmogenic right ventricular cardiomyopathy. Hellenic J Cardiol. 2013; 54(5):394-6. View

12.

Neilan T, Coelho-Filho O, Danik S, Shah R, Dodson J, Verdini D . CMR quantification of myocardial scar provides additive prognostic information in nonischemic cardiomyopathy. JACC Cardiovasc Imaging. 2013; 6(9):944-54. PMC: 3952043. DOI: 10.1016/j.jcmg.2013.05.013. View

13.

Ohnishi Y, Inoue T, Fukuzaki H . Value of the signal-averaged electrocardiogram as a predictor of sudden death in myocardial infarction and dilated cardiomyopathy. Jpn Circ J. 1990; 54(2):127-36. DOI: 10.1253/jcj.54.127. View

14.

Pratola C, Baldo E, Artale P, Marcantoni L, Toselli T, Percoco G . Different image integration modalities to guide AF ablation: impact on procedural and fluoroscopy times. Pacing Clin Electrophysiol. 2011; 34(4):422-30. DOI: 10.1111/j.1540-8159.2010.02989.x. View

15.

Seiler J, Lee J, Roberts-Thomson K, Stevenson W . Intracardiac echocardiography guided catheter ablation of incessant ventricular tachycardia from the posterior papillary muscle causing tachycardia--mediated cardiomyopathy. Heart Rhythm. 2009; 6(3):389-92. DOI: 10.1016/j.hrthm.2008.11.029. View

16.

Callans D, Ren J, Michele J, Marchlinski F, Dillon S . Electroanatomic left ventricular mapping in the porcine model of healed anterior myocardial infarction. Correlation with intracardiac echocardiography and pathological analysis. Circulation. 1999; 100(16):1744-50. DOI: 10.1161/01.cir.100.16.1744. View

17.

Kim R, Fieno D, Parrish T, Harris K, Chen E, Simonetti O . Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. Circulation. 1999; 100(19):1992-2002. DOI: 10.1161/01.cir.100.19.1992. View

18.

Saliba W, Thomas J . Intracardiac echocardiography during catheter ablation of atrial fibrillation. Europace. 2008; 10 Suppl 3:iii42-7. DOI: 10.1093/europace/eun233. View

19.

Gardner P, Ursell P, Fenoglio Jr J, Wit A . Electrophysiologic and anatomic basis for fractionated electrograms recorded from healed myocardial infarcts. Circulation. 1985; 72(3):596-611. DOI: 10.1161/01.cir.72.3.596. View

20.

Berruezo A, Fernandez-Armenta J, Mont L, Zeljko H, Andreu D, Herczku C . Combined endocardial and epicardial catheter ablation in arrhythmogenic right ventricular dysplasia incorporating scar dechanneling technique. Circ Arrhythm Electrophysiol. 2011; 5(1):111-21. DOI: 10.1161/CIRCEP.110.960740. View