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Visualization of the Critical Isthmus by Tracking Delayed Potential in Edited Windows for Scar-Related Ventricular Tachycardia

BACKGROUND AND OBJECTIVES: Identifying the critical isthmus of slow conduction is crucial for successful treatment of scar-related ventricular tachycardia. Current 3D mapping is not designed for tracking the critical isthmus and may lead to a risk of extensive ablation. We edited the algorithm to tr...

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Autores principales: Kim, Ju Youn, Shin, Woo-Seung, Kim, Tae-Seok, Kim, Sung-Hwan, Kim, Ji-Hoon, Jang, Sung-Won, Pak, Hui-Nam, Nam, Gi-Byoung, Lee, Man Young, Rho, Tai-Ho, Oh, Yong Seog
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Cardiology 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720850/
https://www.ncbi.nlm.nih.gov/pubmed/26798386
http://dx.doi.org/10.4070/kcj.2016.46.1.56
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author Kim, Ju Youn
Shin, Woo-Seung
Kim, Tae-Seok
Kim, Sung-Hwan
Kim, Ji-Hoon
Jang, Sung-Won
Pak, Hui-Nam
Nam, Gi-Byoung
Lee, Man Young
Rho, Tai-Ho
Oh, Yong Seog
author_facet Kim, Ju Youn
Shin, Woo-Seung
Kim, Tae-Seok
Kim, Sung-Hwan
Kim, Ji-Hoon
Jang, Sung-Won
Pak, Hui-Nam
Nam, Gi-Byoung
Lee, Man Young
Rho, Tai-Ho
Oh, Yong Seog
author_sort Kim, Ju Youn
collection PubMed
description BACKGROUND AND OBJECTIVES: Identifying the critical isthmus of slow conduction is crucial for successful treatment of scar-related ventricular tachycardia. Current 3D mapping is not designed for tracking the critical isthmus and may lead to a risk of extensive ablation. We edited the algorithm to track the delayed potential in order to visualize the isthmus and compared the edited map with a conventional map. SUBJECTS AND METHODS: We marked every point that showed delayed potential with blue color. After substrate mapping, we edited to reset the annotation from true ventricular potential to delayed potential and then changed the window of interest from the conventional zone (early, 50-60%; late, 40-50% from peak of QRS) to the edited zone (early, 80-90%; late, 10-20%) for every blue point. Finally, we compared the propagation maps before and after editing. RESULTS: We analyzed five scar-related ventricular tachycardia cases. In the propagation maps, the resetting map showed the critical isthmus and entrance and exit sites of tachycardia that showed figure 8 reentry. However, conventional maps only showed the earliest ventricular activation sites and searched for focal tachycardia. All of the tachycardia cases were terminated by ablating the area around the isthmus. CONCLUSION: Identifying the channel and direction of the critical isthmus by a new editing method to track delayed potential is essential in scar-related tachycardia.
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spelling pubmed-47208502016-01-21 Visualization of the Critical Isthmus by Tracking Delayed Potential in Edited Windows for Scar-Related Ventricular Tachycardia Kim, Ju Youn Shin, Woo-Seung Kim, Tae-Seok Kim, Sung-Hwan Kim, Ji-Hoon Jang, Sung-Won Pak, Hui-Nam Nam, Gi-Byoung Lee, Man Young Rho, Tai-Ho Oh, Yong Seog Korean Circ J Original Article BACKGROUND AND OBJECTIVES: Identifying the critical isthmus of slow conduction is crucial for successful treatment of scar-related ventricular tachycardia. Current 3D mapping is not designed for tracking the critical isthmus and may lead to a risk of extensive ablation. We edited the algorithm to track the delayed potential in order to visualize the isthmus and compared the edited map with a conventional map. SUBJECTS AND METHODS: We marked every point that showed delayed potential with blue color. After substrate mapping, we edited to reset the annotation from true ventricular potential to delayed potential and then changed the window of interest from the conventional zone (early, 50-60%; late, 40-50% from peak of QRS) to the edited zone (early, 80-90%; late, 10-20%) for every blue point. Finally, we compared the propagation maps before and after editing. RESULTS: We analyzed five scar-related ventricular tachycardia cases. In the propagation maps, the resetting map showed the critical isthmus and entrance and exit sites of tachycardia that showed figure 8 reentry. However, conventional maps only showed the earliest ventricular activation sites and searched for focal tachycardia. All of the tachycardia cases were terminated by ablating the area around the isthmus. CONCLUSION: Identifying the channel and direction of the critical isthmus by a new editing method to track delayed potential is essential in scar-related tachycardia. The Korean Society of Cardiology 2016-01 2015-11-11 /pmc/articles/PMC4720850/ /pubmed/26798386 http://dx.doi.org/10.4070/kcj.2016.46.1.56 Text en Copyright © 2016 The Korean 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 unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Ju Youn
Shin, Woo-Seung
Kim, Tae-Seok
Kim, Sung-Hwan
Kim, Ji-Hoon
Jang, Sung-Won
Pak, Hui-Nam
Nam, Gi-Byoung
Lee, Man Young
Rho, Tai-Ho
Oh, Yong Seog
Visualization of the Critical Isthmus by Tracking Delayed Potential in Edited Windows for Scar-Related Ventricular Tachycardia
title Visualization of the Critical Isthmus by Tracking Delayed Potential in Edited Windows for Scar-Related Ventricular Tachycardia
title_full Visualization of the Critical Isthmus by Tracking Delayed Potential in Edited Windows for Scar-Related Ventricular Tachycardia
title_fullStr Visualization of the Critical Isthmus by Tracking Delayed Potential in Edited Windows for Scar-Related Ventricular Tachycardia
title_full_unstemmed Visualization of the Critical Isthmus by Tracking Delayed Potential in Edited Windows for Scar-Related Ventricular Tachycardia
title_short Visualization of the Critical Isthmus by Tracking Delayed Potential in Edited Windows for Scar-Related Ventricular Tachycardia
title_sort visualization of the critical isthmus by tracking delayed potential in edited windows for scar-related ventricular tachycardia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720850/
https://www.ncbi.nlm.nih.gov/pubmed/26798386
http://dx.doi.org/10.4070/kcj.2016.46.1.56
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