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Non-invasive focus localization, right ventricular epicardial potential mapping in patients with an MRI-conditional pacemaker system - a pilot study.

van der Graaf AW, Bhagirath P, de Hooge J, Ramanna H, van Driel VJ, de Groot NM, Götte MJ - J Interv Card Electrophysiol (2015)

Bottom Line: The site of epicardial breakthrough was compared to the position of the ventricular lead tip on MRI and the distance between these points was determined.When the tip of the pacing lead was implanted in vicinity to the epicardium, i.e. right ventricular (RV) apex or RV outflow tract, the distance between lead tip position and epicardial breakthrough was 6.0 ± 1.9 mm.In conclusion, the combined MRI and IPM method is clinically applicable and can identify sites of earliest depolarization with a clinically useful accuracy.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Haga Teaching Hospital, Leyweg 275, 2545 CH, The Hague, The Netherlands. a.vandergraaf@hagaziekenhuis.nl.

ABSTRACT

Background: With the advent of magnetic resonance imaging (MRI) conditional pacemaker systems, the possibility of performing MRI in pacemaker patients has been introduced. Besides for the detailed evaluation of atrial and ventricular volumes and function, MRI can be used in combination with body surface potential mapping (BSPM) in a non-invasive inverse potential mapping (IPM) strategy. In non-invasive IPM, epicardial potentials are reconstructed from recorded body surface potentials (BSP). In order to investigate whether an IPM method with a limited number of electrodes could be used for the purpose of non-invasive focus localization, it was applied in patients with implanted pacing devices. Ventricular paced beats were used to simulate ventricular ectopic foci.

Methods: Ten patients with an MRI-conditional pacemaker system and a structurally normal heart were studied. Patient-specific 3D thorax volume models were reconstructed from the MRI images. BSP were recorded during ventricular pacing. Epicardial potentials were inversely calculated from the BSP. The site of epicardial breakthrough was compared to the position of the ventricular lead tip on MRI and the distance between these points was determined.

Results: For all patients, the site of earliest epicardial depolarization could be identified. When the tip of the pacing lead was implanted in vicinity to the epicardium, i.e. right ventricular (RV) apex or RV outflow tract, the distance between lead tip position and epicardial breakthrough was 6.0 ± 1.9 mm.

Conclusions: In conclusion, the combined MRI and IPM method is clinically applicable and can identify sites of earliest depolarization with a clinically useful accuracy.

No MeSH data available.


Related in: MedlinePlus

Complete workflow (a–f) for a non-invasive IPM procedure
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Related In: Results  -  Collection


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Fig1: Complete workflow (a–f) for a non-invasive IPM procedure

Mentions: An overview of the complete workflow is provided in Fig. 1.Fig. 1


Non-invasive focus localization, right ventricular epicardial potential mapping in patients with an MRI-conditional pacemaker system - a pilot study.

van der Graaf AW, Bhagirath P, de Hooge J, Ramanna H, van Driel VJ, de Groot NM, Götte MJ - J Interv Card Electrophysiol (2015)

Complete workflow (a–f) for a non-invasive IPM procedure
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4641154&req=5

Fig1: Complete workflow (a–f) for a non-invasive IPM procedure
Mentions: An overview of the complete workflow is provided in Fig. 1.Fig. 1

Bottom Line: The site of epicardial breakthrough was compared to the position of the ventricular lead tip on MRI and the distance between these points was determined.When the tip of the pacing lead was implanted in vicinity to the epicardium, i.e. right ventricular (RV) apex or RV outflow tract, the distance between lead tip position and epicardial breakthrough was 6.0 ± 1.9 mm.In conclusion, the combined MRI and IPM method is clinically applicable and can identify sites of earliest depolarization with a clinically useful accuracy.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Haga Teaching Hospital, Leyweg 275, 2545 CH, The Hague, The Netherlands. a.vandergraaf@hagaziekenhuis.nl.

ABSTRACT

Background: With the advent of magnetic resonance imaging (MRI) conditional pacemaker systems, the possibility of performing MRI in pacemaker patients has been introduced. Besides for the detailed evaluation of atrial and ventricular volumes and function, MRI can be used in combination with body surface potential mapping (BSPM) in a non-invasive inverse potential mapping (IPM) strategy. In non-invasive IPM, epicardial potentials are reconstructed from recorded body surface potentials (BSP). In order to investigate whether an IPM method with a limited number of electrodes could be used for the purpose of non-invasive focus localization, it was applied in patients with implanted pacing devices. Ventricular paced beats were used to simulate ventricular ectopic foci.

Methods: Ten patients with an MRI-conditional pacemaker system and a structurally normal heart were studied. Patient-specific 3D thorax volume models were reconstructed from the MRI images. BSP were recorded during ventricular pacing. Epicardial potentials were inversely calculated from the BSP. The site of epicardial breakthrough was compared to the position of the ventricular lead tip on MRI and the distance between these points was determined.

Results: For all patients, the site of earliest epicardial depolarization could be identified. When the tip of the pacing lead was implanted in vicinity to the epicardium, i.e. right ventricular (RV) apex or RV outflow tract, the distance between lead tip position and epicardial breakthrough was 6.0 ± 1.9 mm.

Conclusions: In conclusion, the combined MRI and IPM method is clinically applicable and can identify sites of earliest depolarization with a clinically useful accuracy.

No MeSH data available.


Related in: MedlinePlus