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Pouliopoulos J, Chik WW, Kanthan A, Sivagangabalan G, Barry MA, Fahmy PN, Midekin C, Lu J, Kizana E, Thomas SP, Thiagalingam A, Kovoor P. Intramyocardial Adiposity After Myocardial Infarction. Circulation 2013; 128:2296-308. [DOI: 10.1161/circulationaha.113.002238] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Jim Pouliopoulos
- From the Department of Cardiology, Westmead Hospital, Sydney, Australia (J.P., W.W.B.C., G.S., M.A.B., P.N.A.F., C.M., J.L., E.K., S.P.T., A.T., P.K.); University of Sydney, Sydney, Australia (W.W.B.C., A.K., G.S., P.N.A.F., E.K., S.P.T., A.T., P.K.); and Westmead Millennium Institute, Westmead, Australia (P.N.A.F., E.K.)
| | - William W.B. Chik
- From the Department of Cardiology, Westmead Hospital, Sydney, Australia (J.P., W.W.B.C., G.S., M.A.B., P.N.A.F., C.M., J.L., E.K., S.P.T., A.T., P.K.); University of Sydney, Sydney, Australia (W.W.B.C., A.K., G.S., P.N.A.F., E.K., S.P.T., A.T., P.K.); and Westmead Millennium Institute, Westmead, Australia (P.N.A.F., E.K.)
| | - Ajita Kanthan
- From the Department of Cardiology, Westmead Hospital, Sydney, Australia (J.P., W.W.B.C., G.S., M.A.B., P.N.A.F., C.M., J.L., E.K., S.P.T., A.T., P.K.); University of Sydney, Sydney, Australia (W.W.B.C., A.K., G.S., P.N.A.F., E.K., S.P.T., A.T., P.K.); and Westmead Millennium Institute, Westmead, Australia (P.N.A.F., E.K.)
| | - Gopal Sivagangabalan
- From the Department of Cardiology, Westmead Hospital, Sydney, Australia (J.P., W.W.B.C., G.S., M.A.B., P.N.A.F., C.M., J.L., E.K., S.P.T., A.T., P.K.); University of Sydney, Sydney, Australia (W.W.B.C., A.K., G.S., P.N.A.F., E.K., S.P.T., A.T., P.K.); and Westmead Millennium Institute, Westmead, Australia (P.N.A.F., E.K.)
| | - Michael A. Barry
- From the Department of Cardiology, Westmead Hospital, Sydney, Australia (J.P., W.W.B.C., G.S., M.A.B., P.N.A.F., C.M., J.L., E.K., S.P.T., A.T., P.K.); University of Sydney, Sydney, Australia (W.W.B.C., A.K., G.S., P.N.A.F., E.K., S.P.T., A.T., P.K.); and Westmead Millennium Institute, Westmead, Australia (P.N.A.F., E.K.)
| | - Peter N.A. Fahmy
- From the Department of Cardiology, Westmead Hospital, Sydney, Australia (J.P., W.W.B.C., G.S., M.A.B., P.N.A.F., C.M., J.L., E.K., S.P.T., A.T., P.K.); University of Sydney, Sydney, Australia (W.W.B.C., A.K., G.S., P.N.A.F., E.K., S.P.T., A.T., P.K.); and Westmead Millennium Institute, Westmead, Australia (P.N.A.F., E.K.)
| | - Christine Midekin
- From the Department of Cardiology, Westmead Hospital, Sydney, Australia (J.P., W.W.B.C., G.S., M.A.B., P.N.A.F., C.M., J.L., E.K., S.P.T., A.T., P.K.); University of Sydney, Sydney, Australia (W.W.B.C., A.K., G.S., P.N.A.F., E.K., S.P.T., A.T., P.K.); and Westmead Millennium Institute, Westmead, Australia (P.N.A.F., E.K.)
| | - Juntang Lu
- From the Department of Cardiology, Westmead Hospital, Sydney, Australia (J.P., W.W.B.C., G.S., M.A.B., P.N.A.F., C.M., J.L., E.K., S.P.T., A.T., P.K.); University of Sydney, Sydney, Australia (W.W.B.C., A.K., G.S., P.N.A.F., E.K., S.P.T., A.T., P.K.); and Westmead Millennium Institute, Westmead, Australia (P.N.A.F., E.K.)
| | - Eddy Kizana
- From the Department of Cardiology, Westmead Hospital, Sydney, Australia (J.P., W.W.B.C., G.S., M.A.B., P.N.A.F., C.M., J.L., E.K., S.P.T., A.T., P.K.); University of Sydney, Sydney, Australia (W.W.B.C., A.K., G.S., P.N.A.F., E.K., S.P.T., A.T., P.K.); and Westmead Millennium Institute, Westmead, Australia (P.N.A.F., E.K.)
| | - Stuart P. Thomas
- From the Department of Cardiology, Westmead Hospital, Sydney, Australia (J.P., W.W.B.C., G.S., M.A.B., P.N.A.F., C.M., J.L., E.K., S.P.T., A.T., P.K.); University of Sydney, Sydney, Australia (W.W.B.C., A.K., G.S., P.N.A.F., E.K., S.P.T., A.T., P.K.); and Westmead Millennium Institute, Westmead, Australia (P.N.A.F., E.K.)
| | - Aravinda Thiagalingam
- From the Department of Cardiology, Westmead Hospital, Sydney, Australia (J.P., W.W.B.C., G.S., M.A.B., P.N.A.F., C.M., J.L., E.K., S.P.T., A.T., P.K.); University of Sydney, Sydney, Australia (W.W.B.C., A.K., G.S., P.N.A.F., E.K., S.P.T., A.T., P.K.); and Westmead Millennium Institute, Westmead, Australia (P.N.A.F., E.K.)
| | - Pramesh Kovoor
- From the Department of Cardiology, Westmead Hospital, Sydney, Australia (J.P., W.W.B.C., G.S., M.A.B., P.N.A.F., C.M., J.L., E.K., S.P.T., A.T., P.K.); University of Sydney, Sydney, Australia (W.W.B.C., A.K., G.S., P.N.A.F., E.K., S.P.T., A.T., P.K.); and Westmead Millennium Institute, Westmead, Australia (P.N.A.F., E.K.)
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Sivagangabalan G, Pouliopoulos J, Huang K, Lu J, Barry MA, Thiagalingam A, Ross DL, Thomas SP, Kovoor P. Comparison of Electroanatomic Contact and Noncontact Mapping of Ventricular Scar in a Postinfarct Ovine Model With Intramural Needle Electrode Recording and Histological Validation. Circ Arrhythm Electrophysiol 2008; 1:363-9. [DOI: 10.1161/circep.108.799619] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Substrate-based ablation is useful for nonhemodynamically tolerated postinfarct ventricular tachycardia. We assessed the accuracy of the CARTO contact and EnSite noncontact systems at identifying scar in a chronic ovine model with intramural plunge needle electrode recording and histological validation.
Methods and Results—
Scar mapping was performed on 8 male sheep with previous percutaneous-induced myocardial infarction. Up to 20 plunge needles were inserted into the left ventricle of each animal in areas of dense scar, scar border, and normal myocardium. A simultaneous CARTO map and EnSite geometry were acquired using a single catheter, and needle electrode locations were registered. A dynamic substrate map was constructed using ratiometric 50% peak negative voltage. The scar percentage around each needle location was quantified histologically. Analysis was performed on 152 plunge needles and corresponding histological blocks. Spearman correlation with histology was 0.690 (
P
<0.001) for needle electrode peak-to-peak voltage (PPV), 0.362 (
P
<0.001) and 0.492 (
P
<0.001) for CARTO bipolar and unipolar PPV, and 0.381 (
P
<0.001) for EnSite dynamic substrate map (≤40 mm from array). The area under the receiver operator characteristics curve (<50% and ≥50% scar) was 0.896 for needle electrode PPV, 0.726 and 0.697 for CARTO bipolar and unipolar PPV, and 0.703 for EnSite dynamic substrate map (≤40 mm from array).
Conclusions—
Both the CARTO contact and EnSite noncontact systems were moderately accurate in identifying postinfarct scar when compared with intramural electrodes and confirmed with histology. The EnSite dynamic substrate map was comparable to the CARTO contact bipolar PPV when points >40 mm from the array were excluded.
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Affiliation(s)
| | - Jim Pouliopoulos
- From the Cardiology Department, Westmead Hospital, Sydney, Australia
| | - Kaimin Huang
- From the Cardiology Department, Westmead Hospital, Sydney, Australia
| | - Juntang Lu
- From the Cardiology Department, Westmead Hospital, Sydney, Australia
| | - Michael A. Barry
- From the Cardiology Department, Westmead Hospital, Sydney, Australia
| | | | - David L. Ross
- From the Cardiology Department, Westmead Hospital, Sydney, Australia
| | - Stuart P. Thomas
- From the Cardiology Department, Westmead Hospital, Sydney, Australia
| | - Pramesh Kovoor
- From the Cardiology Department, Westmead Hospital, Sydney, Australia
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