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Automated isochronal late activation mapping for substrate characterization in patients with repaired tetralogy of Fallot.
Arana-Rueda, Eduardo; Acosta, Juan; Frutos-López, Manuel; Sánchez-Brotons, Juan-Antonio; González de la Portilla-Concha, Carmen; Gallego, Pastora; Pedrote, Alonso.
Afiliación
  • Arana-Rueda E; Arrhythmia Unit, Department of Cardiology, Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot, s/n, Sevilla 41013, Spain.
  • Acosta J; Instituto de Biomedicina de Sevilla (IBiS), C Antonio Maura Montaner, Sevilla 41013, Spain.
  • Frutos-López M; European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart), Hospital Universitario Virgen del Rocío, Avda Manuel Siurot s/n, Sevilla 41013, Spain.
  • Sánchez-Brotons JA; Arrhythmia Unit, Department of Cardiology, Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot, s/n, Sevilla 41013, Spain.
  • González de la Portilla-Concha C; European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart), Hospital Universitario Virgen del Rocío, Avda Manuel Siurot s/n, Sevilla 41013, Spain.
  • Gallego P; Arrhythmia Unit, Department of Cardiology, Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot, s/n, Sevilla 41013, Spain.
  • Pedrote A; European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart), Hospital Universitario Virgen del Rocío, Avda Manuel Siurot s/n, Sevilla 41013, Spain.
Europace ; 26(3)2024 Mar 01.
Article en En | MEDLINE | ID: mdl-38530796
ABSTRACT

AIMS:

Slow conduction (SC) anatomical isthmuses (AIs) are the dominant substrate for monomorphic ventricular tachycardia (VT) in patients with repaired tetralogy of Fallot (rTF). This study aimed to evaluate the utility of automated propagational analysis for the identification of SC-AI in patients with rTF. METHODS AND

RESULTS:

Consecutive rTF patients undergoing VT substrate characterization were included. Automated isochronal late activation maps (ILAM) were obtained with multielectrode HD Grid Catheter. Identified deceleration zones (DZs) were compared with both SC-AI defined by conduction velocity (CV) (<0.5 m/s) and isthmuses of induced VT for mechanistic correlation. Fourteen patients were included (age 48; p25-75 35-52 years; 57% male), 2 with spontaneous VT and 12 for risk stratification. Nine VTs were inducible in seven patients. Procedure time was 140 (p25-75 133-180) min and mapping time 29.5 (p25-75 20-37.7) min, using a median of 2167 points. All the patients had at least one AI by substrate mapping, identifying a total of 27 (11 SC-AIs). Isochronal late activation maps detected 10 DZs mostly in the AI between ventricular septal defect and pulmonary valve (80%). Five patients had no DZs. A significant negative correlation between number of isochrones/cm and CV was observed (rho -0.87; P < 0.001). Deceleration zones correctly identified SC-AI (90% sensitivity; 100% specificity; 0.94 accuracy) and was related to VT inducibility (P = 0.006). Deceleration zones co-localized to the critical isthmus of induced VTs in 88% of cases. No complications were observed.

CONCLUSION:

Deceleration zones displayed by ILAM during sinus rhythm accurately identify SC-AIs in rTF patients allowing a safe and short-time VT substrate characterization procedure.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Pulmonar / Tetralogía de Fallot / Taquicardia Ventricular / Ablación por Catéter Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Europace Asunto de la revista: CARDIOLOGIA / FISIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Pulmonar / Tetralogía de Fallot / Taquicardia Ventricular / Ablación por Catéter Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Europace Asunto de la revista: CARDIOLOGIA / FISIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido