Novel aggregated multiposition noncontact mapping of atrial tachycardia in humans: From computational modeling to clinical validation
Rattachement africain : gb, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: A novel aggregated multiposition noncontact mapping (AMP-NCM) algorithm is proposed to diagnose cardiac arrhythmias. OBJECTIVE: The purpose of this study was to computationally determine an accuracy threshold and to compare the accuracy and clinical utility of AMP-NCM to gold standard contact mapping. METHODS: In a cellular automata model, the number of catheter positions and chamber coverage were varied to establish accuracy requirements for clinically relevant AMP-NCM. This guided the clinical study protocol. In a prospective cohort of patients with atrial tachycardia (AT), noncontact mapping (NCM) recordings from a single position (SP) and multiple positions were compared to contact mapping with a high-density multipolar catheter using morphology and timing differences of reconstructed signals. Identification of AT mechanisms and ablation targets using both AMP-NCM and contact mapping were randomly evaluated by 5 blinded reviewers. RESULTS: AMP-NCM accuracy was asymptotic at 60 catheter positions in computational modeling. Twenty patients (age 65 ± 12 years; 19 male) with 26 ATs (5 focal, 21 reentrant) were studied. Morphologic correlation of signals derived from AMP-NCM was significantly better than those from SP-NCM compared to contact signals (median 0.93 vs 0.76; P <.001). AMP-NCM generated maps more rapidly than contact mapping (3 ± 1 minutes vs 13 ± 6 minutes; P <.001) and correctly diagnosed AT mechanisms in 25 of 26 maps (96%). Overall, 80% of arrhythmia mechanisms were correctly identified using AMP-NCM by blinded reviewers. CONCLUSION: Once 60 catheter positions were achieved, AMP-NCM successfully diagnosed mechanisms of AT and identified treatment sites equal to gold standard contact mapping in 3 minutes of procedural time.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Novel aggregated multiposition noncontact mapping of atrial tachycardia in humans: From computational modeling to clinical validation
- Date Crossref
- 01/01/2022
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Guy's and St Thomas' NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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Harefield Hospital Heart Rhythm Centre pays non établi dans la noticeÉtablissement de santé
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University of Southern California pays non établi dans la noticeUniversité ou école supérieure
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Papworth Hospital pays non établi dans la noticeÉtablissement de santé
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Cedars-Sinai Medical Center pays non établi dans la noticeÉtablissement de santé
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University of Cambridge pays non établi dans la noticeUniversité ou école supérieure
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Royal Brompton & Harefield NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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Keck School of Medicine Royal Brompton and Harefield Hospitals pays non établi dans la noticeUniversité ou école supérieure
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Acutus Medical pays non établi dans la noticeInstitution
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School of Biological Sciences Royal Papworth Hospital pays non établi dans la noticeUniversité ou école supérieure
Guy's and St Thomas' NHS Foundation Trust, Heart Rhythm Centre — Harefield Hospital et University of Southern California, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.