Feasibility of a noncontact catheter for endocardial mapping of human ventricular tachycardia
Catheter ablation of ventricular tachycardia (VT) is limited by difficulty in identifying suitable sites for ablation. This study assesses use of a system capable of simultaneous endocardial mapping of the human left ventricle to map and guide radiofrequency (RF) catheter ablation of VT. A catheter-...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 1999-05, Vol.99 (19), p.2543-2552 |
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| creator | SCHILLING, R. J PETERS, N. S DAVIES, D. W |
| description | Catheter ablation of ventricular tachycardia (VT) is limited by difficulty in identifying suitable sites for ablation. This study assesses use of a system capable of simultaneous endocardial mapping of the human left ventricle to map and guide radiofrequency (RF) catheter ablation of VT.
A catheter-mounted noncontact multielectrode array was used to reconstruct 3360 electrograms, superimposed onto a computer-simulated endocardial model. Of 24 patients studied, 20 had ischemic heart disease. Exit sites were demonstrated by the noncontact system in 80 (99%) of 81 VTs, with complete VT circuits traced in 17 (21%). In another 37 VTs, 36+/-30% (mean+/-SD) of the diastolic interval was identified. Thirty-eight VT morphologies were ablated with 154 RF energy applications. Successful ablation was achieved by 77% of RF applications to relevant diastolic activity identified by the system and was significantly more likely (P |
| doi_str_mv | 10.1161/01.cir.99.19.2543 |
| format | Article |
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A catheter-mounted noncontact multielectrode array was used to reconstruct 3360 electrograms, superimposed onto a computer-simulated endocardial model. Of 24 patients studied, 20 had ischemic heart disease. Exit sites were demonstrated by the noncontact system in 80 (99%) of 81 VTs, with complete VT circuits traced in 17 (21%). In another 37 VTs, 36+/-30% (mean+/-SD) of the diastolic interval was identified. Thirty-eight VT morphologies were ablated with 154 RF energy applications. Successful ablation was achieved by 77% of RF applications to relevant diastolic activity identified by the system and was significantly more likely (P<0.0001) than by RF at the VT exit or remote from diastolic activation. Over a mean follow-up of 1.5 years, 14 patients (64%) have had no recurrence of VT, and only 2 target VTs (5.3%) have recurred. Five patients have had recurrence of other VTs.
This noncontact mapping system identified diastolic portions of the circuit in most VTs studied and can safely map and guide ablation of human VT.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.cir.99.19.2543</identifier><identifier>PMID: 10330386</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Catheter Ablation - instrumentation ; Catheter Ablation - methods ; Catheterization ; Diseases of the cardiovascular system ; Electrocardiography ; Endocardium - pathology ; Endocardium - physiopathology ; Humans ; Medical sciences ; Middle Aged ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Tachycardia, Ventricular - physiopathology ; Tachycardia, Ventricular - therapy</subject><ispartof>Circulation (New York, N.Y.), 1999-05, Vol.99 (19), p.2543-2552</ispartof><rights>1999 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. May 18, 1999</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c552t-189fcccd17f687c8bd8ffcb1c8a161830c140a5cb8b8ef0752d80d2a7817de773</citedby><cites>FETCH-LOGICAL-c552t-189fcccd17f687c8bd8ffcb1c8a161830c140a5cb8b8ef0752d80d2a7817de773</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,3676,27911,27912</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1788565$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10330386$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SCHILLING, R. J</creatorcontrib><creatorcontrib>PETERS, N. S</creatorcontrib><creatorcontrib>DAVIES, D. W</creatorcontrib><title>Feasibility of a noncontact catheter for endocardial mapping of human ventricular tachycardia</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Catheter ablation of ventricular tachycardia (VT) is limited by difficulty in identifying suitable sites for ablation. This study assesses use of a system capable of simultaneous endocardial mapping of the human left ventricle to map and guide radiofrequency (RF) catheter ablation of VT.
A catheter-mounted noncontact multielectrode array was used to reconstruct 3360 electrograms, superimposed onto a computer-simulated endocardial model. Of 24 patients studied, 20 had ischemic heart disease. Exit sites were demonstrated by the noncontact system in 80 (99%) of 81 VTs, with complete VT circuits traced in 17 (21%). In another 37 VTs, 36+/-30% (mean+/-SD) of the diastolic interval was identified. Thirty-eight VT morphologies were ablated with 154 RF energy applications. Successful ablation was achieved by 77% of RF applications to relevant diastolic activity identified by the system and was significantly more likely (P<0.0001) than by RF at the VT exit or remote from diastolic activation. Over a mean follow-up of 1.5 years, 14 patients (64%) have had no recurrence of VT, and only 2 target VTs (5.3%) have recurred. Five patients have had recurrence of other VTs.
This noncontact mapping system identified diastolic portions of the circuit in most VTs studied and can safely map and guide ablation of human VT.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Catheter Ablation - instrumentation</subject><subject>Catheter Ablation - methods</subject><subject>Catheterization</subject><subject>Diseases of the cardiovascular system</subject><subject>Electrocardiography</subject><subject>Endocardium - pathology</subject><subject>Endocardium - physiopathology</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Tachycardia, Ventricular - physiopathology</subject><subject>Tachycardia, Ventricular - therapy</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkF1rFDEUhoNY2m3tD_BGgoh3M-Zj8nUpi7WFglD0UkLmTOKmzCRrMlPYf-8su6B4dTjwPC_nvAi9paSlVNJPhLYQS2tMS03LRMdfoQ0VrGs6wc1rtCGEmEZxxq7Qda3P6yq5EpfoihLOCddyg37eeVdjH8c4H3AO2OGUE-Q0O5gxuHnnZ19wyAX7NGRwZYhuxJPb72P6dRR2y-QSfvFpLhGW0RW8qrvDiXyDLoIbq789zxv04-7L9-198_jt68P282MDQrC5odoEABioClIr0P2gQ4Cegnbrm5oToB1xAnrdax-IEmzQZGBOaaoGrxS_QR9PufuSfy--znaKFfw4uuTzUq00SqqOdyv4_j_wOS8lrbdZRplcA-URoicISq61-GD3JU6uHCwl9li8JdRuH56sMZYaeyx-dd6dg5d-8sM_xqnpFfhwBlwFN4biEsT6l1NaCyn4H_wLjG0</recordid><startdate>19990518</startdate><enddate>19990518</enddate><creator>SCHILLING, R. J</creator><creator>PETERS, N. S</creator><creator>DAVIES, D. W</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>19990518</creationdate><title>Feasibility of a noncontact catheter for endocardial mapping of human ventricular tachycardia</title><author>SCHILLING, R. J ; PETERS, N. S ; DAVIES, D. W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c552t-189fcccd17f687c8bd8ffcb1c8a161830c140a5cb8b8ef0752d80d2a7817de773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Catheter Ablation - instrumentation</topic><topic>Catheter Ablation - methods</topic><topic>Catheterization</topic><topic>Diseases of the cardiovascular system</topic><topic>Electrocardiography</topic><topic>Endocardium - pathology</topic><topic>Endocardium - physiopathology</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Tachycardia, Ventricular - physiopathology</topic><topic>Tachycardia, Ventricular - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SCHILLING, R. J</creatorcontrib><creatorcontrib>PETERS, N. S</creatorcontrib><creatorcontrib>DAVIES, D. W</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SCHILLING, R. J</au><au>PETERS, N. S</au><au>DAVIES, D. W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feasibility of a noncontact catheter for endocardial mapping of human ventricular tachycardia</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>1999-05-18</date><risdate>1999</risdate><volume>99</volume><issue>19</issue><spage>2543</spage><epage>2552</epage><pages>2543-2552</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Catheter ablation of ventricular tachycardia (VT) is limited by difficulty in identifying suitable sites for ablation. This study assesses use of a system capable of simultaneous endocardial mapping of the human left ventricle to map and guide radiofrequency (RF) catheter ablation of VT.
A catheter-mounted noncontact multielectrode array was used to reconstruct 3360 electrograms, superimposed onto a computer-simulated endocardial model. Of 24 patients studied, 20 had ischemic heart disease. Exit sites were demonstrated by the noncontact system in 80 (99%) of 81 VTs, with complete VT circuits traced in 17 (21%). In another 37 VTs, 36+/-30% (mean+/-SD) of the diastolic interval was identified. Thirty-eight VT morphologies were ablated with 154 RF energy applications. Successful ablation was achieved by 77% of RF applications to relevant diastolic activity identified by the system and was significantly more likely (P<0.0001) than by RF at the VT exit or remote from diastolic activation. Over a mean follow-up of 1.5 years, 14 patients (64%) have had no recurrence of VT, and only 2 target VTs (5.3%) have recurred. Five patients have had recurrence of other VTs.
This noncontact mapping system identified diastolic portions of the circuit in most VTs studied and can safely map and guide ablation of human VT.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>10330386</pmid><doi>10.1161/01.cir.99.19.2543</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Heart Association Journals; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Aged Biological and medical sciences Catheter Ablation - instrumentation Catheter Ablation - methods Catheterization Diseases of the cardiovascular system Electrocardiography Endocardium - pathology Endocardium - physiopathology Humans Medical sciences Middle Aged Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Tachycardia, Ventricular - physiopathology Tachycardia, Ventricular - therapy |
| title | Feasibility of a noncontact catheter for endocardial mapping of human ventricular tachycardia |
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