2 research outputs found
Optimization of a Novel Activation-Repolarization Metric to Identify Targets for Catheter Ablation
Identification of targets for catheter ablation of arrhythmias remains a significant challenge. We have recently
developed a novel substrate mapping procedure, termed
the Reentry Vulnerability Index (RVI), which incorporates
both activation (AT) and repolarization (RT) times to identify ablation targets. Despite showing promise in a series of experiments, the approach requires further development to enable its incorporation into a clinical protocol. The goal of this study was to use computer simulations to optimize the RVI procedure for its future usage
within the clinic. A 2D sheet model was employed to investigate the behavior of the RVI algorithm under mapping catheters recordings resembling clinical conditions.
Conduction block following premature stimulation was induced and mapped in a cardiac tissue model including
repolarization heterogeneity. RVI maps were computed
based on the difference between RTs and ATs between successive pairs of electrodes within a given search radius. A
color map was then constructed to highlight small RVI values which identify vulnerable sites for reentry. Within 2D
sheet models we show that RVI maps computed on sparse
recording sites randomly placed on the tissue surface were
in good agreement with high resolution maps. Moreover,
RVI maps computed on recording sites resembling a decapolar electrode placed linearly as well as on a fan-like
arrangement also captured regions of small RVIs. The RVI
algorithm performed well under a wide range of clinicallyrelevant mapping conditions. The RVI metric was capable
of identifying pro-arrhythmic regions which may be used
to guide ablation
Optimization of a Novel Activation-Repolarization Metric to Identify Targets for Catheter Ablation
Identification of targets for catheter ablation of arrhythmias remains a significant challenge. We have recently
developed a novel substrate mapping procedure, termed
the Reentry Vulnerability Index (RVI), which incorporates
both activation (AT) and repolarization (RT) times to identify ablation targets. Despite showing promise in a series of experiments, the approach requires further development to enable its incorporation into a clinical protocol. The goal of this study was to use computer simulations to optimize the RVI procedure for its future usage
within the clinic. A 2D sheet model was employed to investigate the behavior of the RVI algorithm under mapping catheters recordings resembling clinical conditions.
Conduction block following premature stimulation was induced and mapped in a cardiac tissue model including
repolarization heterogeneity. RVI maps were computed
based on the difference between RTs and ATs between successive pairs of electrodes within a given search radius. A
color map was then constructed to highlight small RVI values which identify vulnerable sites for reentry. Within 2D
sheet models we show that RVI maps computed on sparse
recording sites randomly placed on the tissue surface were
in good agreement with high resolution maps. Moreover,
RVI maps computed on recording sites resembling a decapolar electrode placed linearly as well as on a fan-like
arrangement also captured regions of small RVIs. The RVI
algorithm performed well under a wide range of clinicallyrelevant mapping conditions. The RVI metric was capable
of identifying pro-arrhythmic regions which may be used
to guide ablation