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In vivo left-ventricular contact force analysis: comparison of antegrade transseptal with retrograde transaortic mapping strategies and correlation of impedance and electrical amplitude with contact force
AIMS: Clinical outcomes following radiofrequency ablation of ventricular tachycardias (VTs) depend on catheter tip-to-tissue contact force (CF). Left-ventricular (LV) mapping is performed via antegrade-transseptal or retrograde-transaortic approaches, and the applied CF may depend on the approach us...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4149607/ https://www.ncbi.nlm.nih.gov/pubmed/24493339 http://dx.doi.org/10.1093/europace/eut430 |
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author | Tilz, Roland Richard Makimoto, Hisaki Lin, Tina Rillig, Andreas Metzner, Andreas Mathew, Shibu Deiss, Sebastian Wissner, Erik Rausch, Peter Kamioka, Masashi Heeger, Christian Kuck, Karl-Heinz Ouyang, Feifan |
author_facet | Tilz, Roland Richard Makimoto, Hisaki Lin, Tina Rillig, Andreas Metzner, Andreas Mathew, Shibu Deiss, Sebastian Wissner, Erik Rausch, Peter Kamioka, Masashi Heeger, Christian Kuck, Karl-Heinz Ouyang, Feifan |
author_sort | Tilz, Roland Richard |
collection | PubMed |
description | AIMS: Clinical outcomes following radiofrequency ablation of ventricular tachycardias (VTs) depend on catheter tip-to-tissue contact force (CF). Left-ventricular (LV) mapping is performed via antegrade-transseptal or retrograde-transaortic approaches, and the applied CF may depend on the approach used. This study evaluated (i) the impact of antegrade-transseptal vs. retrograde-transaortic LV-mapping approaches on CF and catheter stability and (ii) the clinical value of the commonly used surrogate markers of catheter–myocardial contact—impedance, unipolar, and bipolar electrogram amplitudes. METHODS AND RESULTS: An antegrade-transseptal and a retrograde-transaortic LV-mapping approach was performed in 10 patients undergoing VT ablation by using CF-sensing catheters. Operators were blinded to CF data and data were analysed according to 11 predefined LV segments. Three thousand three hundred and twenty-four mapping points (1577 antegrade, 1747 retrograde) were analysed, including 80 (2.4%) points with maximum CF > 100 g. Median antegrade and retrograde CF were 16.0 g (q1–q3; 8.4–26.2) and 15.3 g (9.8–23.4), respectively. Contact force was significantly higher antegradely in mid-anteroseptum, mid-lateral, and apical segments, and significantly higher retrogradely in basal-anteroseptum, basal-inferoseptum, basal-inferior, and basal-lateral segments. Contact force did correlate with impedance, unipolar, and bipolar electrogram amplitudes; however, there were large overlaps. CONCLUSIONS: Antegrade vs. retrograde LV-mapping approaches result in different CF. A combined approach to the LV mapping may improve the overall LV mapping, potentially resulting in better clinical outcomes for the left VT catheter ablation. The previous surrogate markers used to assess CF do correlate with in vivo CF; however, due to a larger overlap, their clinical value is limited. |
format | Online Article Text |
id | pubmed-4149607 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-41496072014-09-02 In vivo left-ventricular contact force analysis: comparison of antegrade transseptal with retrograde transaortic mapping strategies and correlation of impedance and electrical amplitude with contact force Tilz, Roland Richard Makimoto, Hisaki Lin, Tina Rillig, Andreas Metzner, Andreas Mathew, Shibu Deiss, Sebastian Wissner, Erik Rausch, Peter Kamioka, Masashi Heeger, Christian Kuck, Karl-Heinz Ouyang, Feifan Europace Technical Issues AIMS: Clinical outcomes following radiofrequency ablation of ventricular tachycardias (VTs) depend on catheter tip-to-tissue contact force (CF). Left-ventricular (LV) mapping is performed via antegrade-transseptal or retrograde-transaortic approaches, and the applied CF may depend on the approach used. This study evaluated (i) the impact of antegrade-transseptal vs. retrograde-transaortic LV-mapping approaches on CF and catheter stability and (ii) the clinical value of the commonly used surrogate markers of catheter–myocardial contact—impedance, unipolar, and bipolar electrogram amplitudes. METHODS AND RESULTS: An antegrade-transseptal and a retrograde-transaortic LV-mapping approach was performed in 10 patients undergoing VT ablation by using CF-sensing catheters. Operators were blinded to CF data and data were analysed according to 11 predefined LV segments. Three thousand three hundred and twenty-four mapping points (1577 antegrade, 1747 retrograde) were analysed, including 80 (2.4%) points with maximum CF > 100 g. Median antegrade and retrograde CF were 16.0 g (q1–q3; 8.4–26.2) and 15.3 g (9.8–23.4), respectively. Contact force was significantly higher antegradely in mid-anteroseptum, mid-lateral, and apical segments, and significantly higher retrogradely in basal-anteroseptum, basal-inferoseptum, basal-inferior, and basal-lateral segments. Contact force did correlate with impedance, unipolar, and bipolar electrogram amplitudes; however, there were large overlaps. CONCLUSIONS: Antegrade vs. retrograde LV-mapping approaches result in different CF. A combined approach to the LV mapping may improve the overall LV mapping, potentially resulting in better clinical outcomes for the left VT catheter ablation. The previous surrogate markers used to assess CF do correlate with in vivo CF; however, due to a larger overlap, their clinical value is limited. Oxford University Press 2014-09 2014-02-02 /pmc/articles/PMC4149607/ /pubmed/24493339 http://dx.doi.org/10.1093/europace/eut430 Text en © The Author 2014. Published by Oxford University Press on behalf of the European Society of Cardiology. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com. |
spellingShingle | Technical Issues Tilz, Roland Richard Makimoto, Hisaki Lin, Tina Rillig, Andreas Metzner, Andreas Mathew, Shibu Deiss, Sebastian Wissner, Erik Rausch, Peter Kamioka, Masashi Heeger, Christian Kuck, Karl-Heinz Ouyang, Feifan In vivo left-ventricular contact force analysis: comparison of antegrade transseptal with retrograde transaortic mapping strategies and correlation of impedance and electrical amplitude with contact force |
title | In vivo left-ventricular contact force analysis: comparison of antegrade transseptal with retrograde transaortic mapping strategies and correlation of impedance and electrical amplitude with contact force |
title_full | In vivo left-ventricular contact force analysis: comparison of antegrade transseptal with retrograde transaortic mapping strategies and correlation of impedance and electrical amplitude with contact force |
title_fullStr | In vivo left-ventricular contact force analysis: comparison of antegrade transseptal with retrograde transaortic mapping strategies and correlation of impedance and electrical amplitude with contact force |
title_full_unstemmed | In vivo left-ventricular contact force analysis: comparison of antegrade transseptal with retrograde transaortic mapping strategies and correlation of impedance and electrical amplitude with contact force |
title_short | In vivo left-ventricular contact force analysis: comparison of antegrade transseptal with retrograde transaortic mapping strategies and correlation of impedance and electrical amplitude with contact force |
title_sort | in vivo left-ventricular contact force analysis: comparison of antegrade transseptal with retrograde transaortic mapping strategies and correlation of impedance and electrical amplitude with contact force |
topic | Technical Issues |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4149607/ https://www.ncbi.nlm.nih.gov/pubmed/24493339 http://dx.doi.org/10.1093/europace/eut430 |
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