Combined ventricular endocardial and epicardial substrate mapping using a sonomicrometry-based electroanatomical mapping system

Andre D'Avila, Aravinda Thiagalingam, Jeremy N. Ruskin, Vivek Y. Reddy

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Substrate mapping using a magnetic electroanatomical mapping system (MEAM) has been shown to accurately delineate the location/extent of scarred myocardium. This study examined the ability of a sonomicrometry-based electroanatomic mapping system (SEAM) to render endocardial and epicardial substrate maps of infarcted ventricular myocardium. Methods and Results: In 7 swine with healed myocardial infarctions, combined epicardial and endocardial left ventricular (LV) substrate maps were created with both SEAM and MEAM mapping systems using 246±68 and 244±44 points respectively. Scarred myocardium was identified based upon bipolar electrogram amplitude < 1.5 mV, and radiofrequency ablation lesions were delivered to the scar border as defined by the sonomicrometry mapping system. The LV endocardial chamber volume as defined by SEAM (125±46 ml) correlated well with that defined by the MEAM (137±45 ml, r=0.77, p < 0.05). The area of infarcted tissue as determined by SEAM was highly correlated with that determined by gross pathology (r=0.96 for endocardial scar and r=0.92 for epicardial scar p < 0.05). The scar area calculated by the SEAM system also correlated well with the scar area determined by the MEAM system (0.91 for endocardial scar and 0.90 for epicardial scar p < 0.05). Finally, the sonomicrometry-based system was able to guide the placement of radiofrequency ablation lesions to the borders of the scar. Conclusions: This study demonstrates that the sonomicrometry-based mapping can accurately reconstruct three-dimensional voltage maps of the endocardial and epicardial ventricular surfaces and guide the placement of ablation lesions along the scar border zone.

Original languageEnglish
Pages (from-to)781-786
Number of pages6
JournalPACE - Pacing and Clinical Electrophysiology
Volume30
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

Keywords

  • Catheter ablation
  • Epicardium
  • Myocardial infarction
  • Pericardium
  • Ventricular tachycardia

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