Journal article
P5691Independent assessment if an image-processing service for the treatment of patients with ventricular tachycardias
- Spies, F University Hospital Basel, Cardiology, Basel, Switzerland
- Kuhne, M University Hospital Basel, Cardiology, Basel, Switzerland
- Brantner, P University Hospital Basel, Cardiology, Basel, Switzerland
- Haaf, P University Hospital Basel, Cardiology, Basel, Switzerland
- Zeljkovic, I University Hospital Basel, Cardiology, Basel, Switzerland
- Madaffari, A University Hospital Basel, Cardiology, Basel, Switzerland
- Reichlin, T University Hospital Basel, Cardiology, Basel, Switzerland
- Osswald, S University Hospital Basel, Cardiology, Basel, Switzerland
- Sticherling, C University Hospital Basel, Cardiology, Basel, Switzerland
- Knecht, S University Hospital Basel, Cardiology, Basel, Switzerland
- 2019-10-21
Published in:
- European Heart Journal. - Oxford University Press (OUP). - 2019, vol. 40, no. Supplement_1
English
Abstract
Background/Introduction
Substrate-based radiofrequency ablation (RFA) in combination with pre-procedural computed tomography (CT) or cardiac Magnetic Resonance Imaging (cMRI) emerged as a promising approach to treat ventricular tachycardias (VT). However, image-processing and 3D reconstruction of the relevant structures to embed them into a 3D electroanatomical mapping (EAM) system is time consuming and requires highly experienced personal and a dedicated software.
Purpose
The aim of the study was to present the first independent experience with a commercially available service of a internet platform in patients referred for RFA of VTs.
Methods
Seven consecutive patients (pts) with ischemic cardiomyopathy (ICM), non- ischemic cardiomyopathy (NICM) and dilated cardiomyopathy (DCM) referred for VT RFA underwent contrast-enhanced dual-energy CT. The anonymized DICOM dataset was uploaded to the internet platform. After processing by the specialists, the dataset was downloaded and exported in a format compatible with the 3D EAM System. The EAM was performed in sinus rhythm using a 3.5mm open-irrigated tip catheter or a magnetic remote 3.5mm open-irrigated tip catheter in combination with the remote magnetic navigation-system. A multipolar high-density mapping catheter was used in 6 pts. Scar was defined as bipolar voltage <0.5 mV, and scar border zone ≥0.5mV and <1.5 mV.
Results of the internet platform-derived wall thinning (WT), scars and the defined substrate based on 3d EAM voltage maps were transferred into a 17-segment model, and the filling of every single segment was rated as 0%, 25%, 50%, 75% and 100%. For analysis, agreement of the filling (percentage) of the individual segments was quantified.
Results
Mean age was 67±8 year, BMI was 28±5 kg/m2 and 86% were males. File transfers and image processing was feasible in all patients. Agreement between the defined substrate (<0,5mV) and WT of 4mm was very good (≥90%) in 3 pts, good (≥75% & <90%) in one patient, moderate (≥50% & <75%) in one patient and poor (<50%) in one patient.
Patient #1 #2 #3 #4 #5 #6 #7 Sex male male male female male male male Age 63y 56y 71y 65y 60y 69y 81y BMI 31kg/m2 32kg/m2 19kg/m2 25kg/m2 28kg/m2 34kg/m2 29kg/m2 LVEF 25% 60% 25% 25% 25% 31% 34% EDVI 123ml/m2 184ml/m2 69ml/m2 114ml/m2 142ml/m2 105ml/m2 75ml/m2 Catheter multipolar high-density + 3.5mm open-irrigated tip 3.5mm open-irrigated tip multipolar high-density + 3.5mm open-irrigated tip multipolar high-density + 3.5mm open-irrigated tip multipolar high-density + magnetic remote 3.5mm open-irrigated tip multipolar high-density + magnetic remote 3.5mm open-irrigated tip multipolar high-density + magnetic remote 3.5mm open-irrigated tip Quality 98% 96% 91% 66% 89% no match 53% Quality = Percentage match between defined substrate and WT.
Superimpose – wall thinning and FAM
Conclusion(s)
Integration of substrate-based segmentation using the service of the internet platform is feasible in daily practice. Agreement between voltage-map based substrate definition and internet platform-based WT was satisfactory in the majority of patients.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1093/eurheartj/ehz746.0633
- ISSN 0195-668X
- Persistent URL
- https://sonar.ch/global/documents/195028
Statistics
Document views: 18
File downloads: