Accuracy of standard bipolar amplitude voltage thresholds to identify late potential channels in ventricular tachycardia ablation
Background: Ventricular tachycardia (VT) is caused by the presence of a slow conduction channel (CC) of border zone (BZ) tissue inside the scar-core tissue. Electroanatomic mapping can depict this tissue by voltage mapping. Areas of slow conduction can be detected as late potentials (LPs) and their...
| Autores: | ; ; ; ; ; ; ; ; ; ; |
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| Tipo de documento: | Artículo |
| Estado: | Published version |
| Fecha de publicación: | 2022 |
| País: | España |
| Institución: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/214271 |
| Acceso en línea: | https://hdl.handle.net/2445/214271 |
| Nivel de acceso: | Acceso abierto |
| Palabra clave: | Taquicàrdia Ventricles cardíacs Cicatrius Malalties del cor Tachycardia Ventricle of heart Scars Heart diseases |
| _version_ | 1878740259278159873 |
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| author | Roca Luque, Ivo |
| author2 | Zaraket, Fatima Garre Anguera de Sojo, Paz Sánchez Somonte, Paula Quinto, Levio Borràs, Roger Guasch i Casany, Eduard Arbelo, Elena Tolosana, José M. (José María) Brugada Terradellas, Josep, 1958- Mont Girbau, Lluís |
| author2_role | author author author author author author author author author author |
| author_browse | Arbelo, Elena Borràs, Roger Brugada Terradellas, Josep, 1958- Garre Anguera de Sojo, Paz Guasch i Casany, Eduard Mont Girbau, Lluís Quinto, Levio Roca Luque, Ivo Sánchez Somonte, Paula Tolosana, José M. (José María) Zaraket, Fatima |
| author_facet | Roca Luque, Ivo Zaraket, Fatima Garre Anguera de Sojo, Paz Sánchez Somonte, Paula Quinto, Levio Borràs, Roger Guasch i Casany, Eduard Arbelo, Elena Tolosana, José M. (José María) Brugada Terradellas, Josep, 1958- Mont Girbau, Lluís |
| author_role | author |
| collection | Dipòsit Digital de la UB |
| description | Background: Ventricular tachycardia (VT) is caused by the presence of a slow conduction channel (CC) of border zone (BZ) tissue inside the scar-core tissue. Electroanatomic mapping can depict this tissue by voltage mapping. Areas of slow conduction can be detected as late potentials (LPs) and their abolition is the most accepted ablation endpoint. In the current guidelines, bipolar voltage thresholds for BZ and core scar are 1.5 and 0.5 mV respectively. The performance of these values is controversial. The aim of the study is to analyze the diagnostic yield of current amplitude thresholds in voltage map to define VT substrate in terms of CCs of LPs. Predictors of usefulness of current thresholds will be analyzed. Methods: All patients with structural heart disease who underwent VT ablation in Hospital Clinic in 2016-2017 were included. Maps with delineation of CCs based on LPs were created with contact force sensor catheter. Thresholds were adjusted for every patient based on CCs. Diagnostic yield and predictors of performance of conventional thresholds were analyzed. Results: During study period, 57 consecutive patients were included (age: 60.4 ± 8.5; 50.2% ischemic cardiomyopathy, LVEF 39.8 ± 13.5%). Cutoff voltages that better identified the scar and BZ according to the LP channels were 0.32 (0.02-2 mV) and 1.84 (0.3-6 mV) respectively. Current voltage thresholds identified correctly core and BZ in 87.7% and 42.1% of the patients respectively. Accuracy was worse in non-ischemic cardiomyopathy (NICM) especially for BZ (28.6% vs 55.2%, p = 0.042). Conclusions: Accuracy of standard voltage thresholds for scar and BZ is poor in terms of LPs detection. Diagnostic yield is worse in NICM patients specially for border zone. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_cfe3b864e524dcd8d6a764a97a979c95 |
| institution | Universidad de Barcelona |
| instname_str | Universidad de Barcelona |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:diposit.ub.edu:2445/214271 |
| publishDate | 2022 |
| publishDateSort | 2022 |
| publisher | Springer Verlag |
| publisherStr | Springer Verlag |
| reponame_str | Dipòsit Digital de la UB |
| spelling | Accuracy of standard bipolar amplitude voltage thresholds to identify late potential channels in ventricular tachycardia ablation Roca Luque, Ivo Zaraket, Fatima Garre Anguera de Sojo, Paz Sánchez Somonte, Paula Quinto, Levio Borràs, Roger Guasch i Casany, Eduard Arbelo, Elena Tolosana, José M. (José María) Brugada Terradellas, Josep, 1958- Mont Girbau, Lluís Taquicàrdia Ventricles cardíacs Cicatrius Malalties del cor Tachycardia Ventricle of heart Scars Heart diseases Background: Ventricular tachycardia (VT) is caused by the presence of a slow conduction channel (CC) of border zone (BZ) tissue inside the scar-core tissue. Electroanatomic mapping can depict this tissue by voltage mapping. Areas of slow conduction can be detected as late potentials (LPs) and their abolition is the most accepted ablation endpoint. In the current guidelines, bipolar voltage thresholds for BZ and core scar are 1.5 and 0.5 mV respectively. The performance of these values is controversial. The aim of the study is to analyze the diagnostic yield of current amplitude thresholds in voltage map to define VT substrate in terms of CCs of LPs. Predictors of usefulness of current thresholds will be analyzed. Methods: All patients with structural heart disease who underwent VT ablation in Hospital Clinic in 2016-2017 were included. Maps with delineation of CCs based on LPs were created with contact force sensor catheter. Thresholds were adjusted for every patient based on CCs. Diagnostic yield and predictors of performance of conventional thresholds were analyzed. Results: During study period, 57 consecutive patients were included (age: 60.4 ± 8.5; 50.2% ischemic cardiomyopathy, LVEF 39.8 ± 13.5%). Cutoff voltages that better identified the scar and BZ according to the LP channels were 0.32 (0.02-2 mV) and 1.84 (0.3-6 mV) respectively. Current voltage thresholds identified correctly core and BZ in 87.7% and 42.1% of the patients respectively. Accuracy was worse in non-ischemic cardiomyopathy (NICM) especially for BZ (28.6% vs 55.2%, p = 0.042). Conclusions: Accuracy of standard voltage thresholds for scar and BZ is poor in terms of LPs detection. Diagnostic yield is worse in NICM patients specially for border zone. Springer Verlag https://hdl.handle.net/2445/214271 |
| spellingShingle | Accuracy of standard bipolar amplitude voltage thresholds to identify late potential channels in ventricular tachycardia ablation Roca Luque, Ivo Taquicàrdia Ventricles cardíacs Cicatrius Malalties del cor Tachycardia Ventricle of heart Scars Heart diseases |
| status_str | publishedVersion |
| title | Accuracy of standard bipolar amplitude voltage thresholds to identify late potential channels in ventricular tachycardia ablation |
| title_full | Accuracy of standard bipolar amplitude voltage thresholds to identify late potential channels in ventricular tachycardia ablation |
| title_fullStr | Accuracy of standard bipolar amplitude voltage thresholds to identify late potential channels in ventricular tachycardia ablation |
| title_full_unstemmed | Accuracy of standard bipolar amplitude voltage thresholds to identify late potential channels in ventricular tachycardia ablation |
| title_short | Accuracy of standard bipolar amplitude voltage thresholds to identify late potential channels in ventricular tachycardia ablation |
| title_sort | Accuracy of standard bipolar amplitude voltage thresholds to identify late potential channels in ventricular tachycardia ablation |
| topic | Taquicàrdia Ventricles cardíacs Cicatrius Malalties del cor Tachycardia Ventricle of heart Scars Heart diseases |
| topic_facet | Taquicàrdia Ventricles cardíacs Cicatrius Malalties del cor Tachycardia Ventricle of heart Scars Heart diseases |
| url | https://hdl.handle.net/2445/214271 |