Dynamic changes in electrogram morphology at functional lines of block in reentrant circuits during ventricular tachycardia in the infarcted canine heart: A new method to localize reentrant circuits from electrogram features using adaptive template matching

被引:14
作者
Ciaccio, EJ
Scheinman, MM
Fridman, V
Schmitt, H
Coromilas, J
Wit, AL
机构
[1] Columbia Univ Coll Phys & Surg, Dept Pharmacol, New York, NY 10032 USA
[2] Columbia Univ Coll Phys & Surg, Dept Med, New York, NY 10032 USA
[3] Columbia Univ Coll Phys & Surg, Ctr Biomed Engn, New York, NY 10032 USA
[4] Univ Calif San Francisco, Dept Med, San Francisco, CA USA
关键词
reentry; mapping; electrograms; ventricular tachycardia; ablation;
D O I
10.1111/j.1540-8167.1999.tb00661.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Localization of Reentrant Circuits Using ATM, Introduction: Fractionated, low-amplitude or long-duration electrograms have limited specificity for locating reentrant circuits causing ventricular tachycardia (VT), In this study a new method is described, adaptive template matching (ATM), based on the quantification of beat-to-beat changes in electrograms, for locating functional reentrant circuits that are relatively stable and cause monomorphic VT, Methods and Results: Monomorphic VTs were induced in 4-day-old infarcted canine hearts by programmed stimulation and reentrant circuits mapped in the epicardial border zone with a 196 or 312 bipolar electrode array, For ATM analysis, a template electrogram from each electrode, during an early cycle, was matched with all subsequent (input) electrograms at the same site by weighting the inputs of amplitude, duration, average baseline, and phase lag. The mean square error (MSE) between template and input was the criterion used to adapt the weights, and was also a measure of changes in electrogram shape that occur from cycle to cycle. The variance of each of the weighting parameters at all electrode sites were plotted on a representation of the electrode array, and the location of the functional lines of block bounding the central common pathway of reentrant circuits with figure-of-eight characteristics, overlaid on the ATM map. Peaks of high variance were found to be coincident with functional lines of block during all tachycardia episodes. Conclusion: Specific beat-to-beat changes in electrograms occur at functional lines of block in reentrant circuits that can be quantified by ATM analysis, suggesting that these regions might be located;without activation mapping, The method might be useful to guide ablation catheter position.
引用
收藏
页码:194 / 213
页数:20
相关论文
共 37 条
[1]   CIRCUS MOVEMENT IN RABBIT ATRIAL MUSCLE AS A MECHANISM OF TACHYCARDIA .3. LEADING CIRCLE CONCEPT - NEW MODEL OF CIRCUS MOVEMENT IN CARDIAC TISSUE WITHOUT INVOLVEMENT OF AN ANATOMICAL OBSTACLE [J].
ALLESSIE, MA ;
BONKE, FIM ;
SCHOPMAN, FJG .
CIRCULATION RESEARCH, 1977, 41 (01) :9-18
[2]   SLOW VENTRICULAR ACTIVATION IN ACUTE MYOCARDIAL-INFARCTION - SOURCE OF REENTRANT PREMATURE VENTRICULAR CONTRACTIONS [J].
BOINEAU, JP ;
COX, JL .
CIRCULATION, 1973, 48 (04) :702-713
[3]   Prediction of the location and time of spontaneous termination of reentrant ventricular tachycardia for radiofrequency catheter ablation therapy [J].
Ciaccio, EJ ;
Wit, AL ;
Scheinman, MM .
JOURNAL OF ELECTROCARDIOLOGY, 1995, 28 :165-173
[4]  
CIACCIO EJ, 1995, ELECTROCARDIOLOGY CE, P605
[5]   ELECTROPHYSIOLOGICAL EFFECTS OF FLECAINIDE ON ANISOTROPIC CONDUCTION AND REENTRY IN INFARCTED CANINE HEARTS [J].
COROMILAS, J ;
SALTMAN, AE ;
WALDECKER, B ;
DILLON, SM ;
WIT, AL .
CIRCULATION, 1995, 91 (08) :2245-2263
[6]   REENTRY AS A CAUSE OF VENTRICULAR-TACHYCARDIA IN PATIENTS WITH CHRONIC ISCHEMIC HEART-DISEASE - ELECTROPHYSIOLOGIC AND ANATOMIC CORRELATION [J].
DEBAKKER, JMT ;
VANCAPELLE, FJL ;
JANSE, MJ ;
WILDE, AAM ;
CORONEL, R ;
BECKER, AE ;
DINGEMANS, KP ;
VANHEMEL, NM ;
HAUER, RNW .
CIRCULATION, 1988, 77 (03) :589-606
[7]   INFLUENCES OF ANISOTROPIC TISSUE STRUCTURE ON REENTRANT CIRCUITS IN THE EPICARDIAL BORDER ZONE OF SUBACUTE CANINE INFARCTS [J].
DILLON, SM ;
ALLESSIE, MA ;
URSELL, PC ;
WIT, AL .
CIRCULATION RESEARCH, 1988, 63 (01) :182-206
[8]   ENDOCARDIAL MAPPING OF VENTRICULAR-TACHYCARDIA IN THE INTACT HUMAN VENTRICLE - EVIDENCE FOR REENTRANT MECHANISMS [J].
DOWNAR, E ;
HARRIS, L ;
MICKLEBOROUGH, LL ;
SHAIKH, N ;
PARSON, ID .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1988, 11 (04) :783-791
[9]   REENTRANT VENTRICULAR ARRHYTHMIAS IN THE LATE MYOCARDIAL-INFARCTION PERIOD - INTERRUPTION OF REENTRANT CIRCUITS BY CRYOTHERMAL TECHNIQUES [J].
ELSHERIF, N ;
MEHRA, R ;
GOUGH, WB ;
ZEILER, RH .
CIRCULATION, 1983, 68 (03) :644-656
[10]  
ELSHERIF N, 1995, CARDIAC ELECTROPHYSI, P363