TY - JOUR
T1 - Right ventricular substrate mapping using the Ensite Navx system
T2 - Accuracy of high-density voltage map obtained by automatic point acquisition during geometry reconstruction
AU - Casella, Michela
AU - Perna, Francesco
AU - Dello Russo, Antonio
AU - Pelargonio, Gemma
AU - Bartoletti, Stefano
AU - Ricco, Annalisa
AU - Sanna, Tommaso
AU - Pieroni, Maurizio
AU - Forleo, Giovanni
AU - Pappalardo, Augusto
AU - Di Biase, Luigi
AU - Natale, Luigi
AU - Bellocci, Fulvio
AU - Zecchi, Paolo
AU - Natale, Andrea
AU - Tondo, Claudio
PY - 2009/11
Y1 - 2009/11
N2 - Background: Contact point-to-point electroanatomic mapping (Pt-Map) is a validated tool to evaluate right ventricular (RV) substrate. When using the EnSite NavX system (St. Jude Medical, St Paul, Minnesota), geometry reconstruction by dragging the mapping catheter (Geo-Map) allows for quicker acquisition of a large number of points and better definition of anatomy, but it is not validated for substrate mapping. Objective: This study evaluates the feasibility and accuracy of Geo-Map. Methods: Thirteen patients (mean age 38 ± 12 years) with RV arrhythmias and an apparently normal heart underwent cardiac magnetic resonance imaging (MRI), Pt-Map, and Geo-Map. The 2 maps were compared in terms of mapping procedural time, radiation time, and total number of points acquired. We finally compared the number and characteristics of low-potential areas on each patient's Pt-Map, Geo-Map, and cardiac MRI. Results: Geo-Map required significantly shorter mapping and radiation times in comparison to Pt-Map (12.4 ± 4.6 vs. 31.9 ± 10.1 and 5.8 ± 2.1 vs. 12.1 ± 3.9, P <.001). Furthermore, Geo-Map was based on a significantly higher density of points in comparison to Pt-Map (802 ± 205 vs. 194 ± 38, P <.001). Taking into consideration the total number of RV regions analyzed, the Pt-Map and Geo-Map disagreed in 2 of 65 (3%) regions (P = NS), which only Geo-Map identified as low-potential areas and indeed corresponded to wall motion abnormalities on MRI. Conclusion: Voltage maps obtained through RV geometry acquisition have accuracy comparable to that of conventional point-by-point mapping in detecting low-voltage areas, have a good correlation with MRI wall motion abnormalities, and allow a significant reduction in procedural time and x-ray exposure.
AB - Background: Contact point-to-point electroanatomic mapping (Pt-Map) is a validated tool to evaluate right ventricular (RV) substrate. When using the EnSite NavX system (St. Jude Medical, St Paul, Minnesota), geometry reconstruction by dragging the mapping catheter (Geo-Map) allows for quicker acquisition of a large number of points and better definition of anatomy, but it is not validated for substrate mapping. Objective: This study evaluates the feasibility and accuracy of Geo-Map. Methods: Thirteen patients (mean age 38 ± 12 years) with RV arrhythmias and an apparently normal heart underwent cardiac magnetic resonance imaging (MRI), Pt-Map, and Geo-Map. The 2 maps were compared in terms of mapping procedural time, radiation time, and total number of points acquired. We finally compared the number and characteristics of low-potential areas on each patient's Pt-Map, Geo-Map, and cardiac MRI. Results: Geo-Map required significantly shorter mapping and radiation times in comparison to Pt-Map (12.4 ± 4.6 vs. 31.9 ± 10.1 and 5.8 ± 2.1 vs. 12.1 ± 3.9, P <.001). Furthermore, Geo-Map was based on a significantly higher density of points in comparison to Pt-Map (802 ± 205 vs. 194 ± 38, P <.001). Taking into consideration the total number of RV regions analyzed, the Pt-Map and Geo-Map disagreed in 2 of 65 (3%) regions (P = NS), which only Geo-Map identified as low-potential areas and indeed corresponded to wall motion abnormalities on MRI. Conclusion: Voltage maps obtained through RV geometry acquisition have accuracy comparable to that of conventional point-by-point mapping in detecting low-voltage areas, have a good correlation with MRI wall motion abnormalities, and allow a significant reduction in procedural time and x-ray exposure.
KW - Arrhythmogenic right ventricular dysplasia
KW - Cardiac magnetic resonance imaging
KW - Electroanatomic mapping
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U2 - 10.1016/j.hrthm.2009.07.040
DO - 10.1016/j.hrthm.2009.07.040
M3 - Article
C2 - 19786371
AN - SCOPUS:70350573549
SN - 1547-5271
VL - 6
SP - 1598
EP - 1605
JO - Heart Rhythm
JF - Heart Rhythm
IS - 11
ER -