B-PO04-132 INCREASED CATHETER STABILITY FOR ACTIVATION MAPPING OF PAPILLARY MUSCLE PVCS UTILIZING THE ABBOTT HD GRID MAPPING CATHETER

Abstract Background The Advisor™ HD Grid Mapping Catheter (Abbott Technologies, Minneapolis, MN) has been recently introduced. Although the clinical use of HD Grid mapping catheter is well described in adults with no congenital heart disease, there is limited data on the feasibility of using the HD Grid multipolar catheter to create voltage and activation mapping in adults with congenital heart disease. The purpose of this study was to evaluate the safety and technical feasibility of using the Advisor™ HD Grid mapping catheter during the catheter ablation of atrial arrhythmias in adults with congenital heart disease. We included 6 consecutive adults with congenital heart disease suffering from atrial arrhythmias in our study. The HD Grid mapping catheter was used to perform voltage and activation mapping. Results Six patients with congenital heart diseases (d-TGA n = 1, Tricuspid atresia n = 1, atrioventricular defect repair n = 1, secundum atrial septal defect n = 1, double-inlet single-ventricle n = 1, Tetralogy of Fallot = 1); majority (84%) male, with the mean age was 35 ± 10 years included in our series. The mean ablation duration and the fluoroscopy time were 789 ± 433 and 502 ± 355 s, respectively. The mean radiation dose was 7.52 ± 9 milliGy/cm2. The HD Grid mapping catheter was used successfully for entire arrhythmia mapping in 5 out of 6 cases. During one procedure, HD Grid mapping catheter could not be used for the entire mapping due to suboptimal reach through baffle puncture. The acute success rate of ablation was 100% with no immediate complications. Conclusions The use of HD Grid mapping catheter is a safe and valuable adjunct to accurately create voltage and activation mapping in ACHD patients undergoing radiofrequency catheter ablation. However, a contact force-sensing ablation catheter should be considered in conjunction to supplement data acquisition in challenging anatomy and substrates.

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Impact on Practice with the Advisor™ HD Grid Mapping Catheter, Sensor Enabled™

Journal of Innovations in Cardiac Rhythm Management ◽

10.19102/icrm.2021.120125s ◽

2020 ◽

Vol 12 (S1) ◽

pp. 65-67

Author(s):

Toshimasa Okabe ◽

Ashit Patel ◽

Roderick Tung ◽

Christopher Woods

Keyword(s):

Grid Mapping ◽

Mapping Catheter

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Multiple simultaneous mid‐diastolic potentials recorded on a grid mapping catheter during a scar‐related reentrant ventricular tachycardia: Are all potentials within a critical isthmus?

Journal of Cardiovascular Electrophysiology ◽

10.1111/jce.14230 ◽

2019 ◽

Vol 30 (12) ◽

pp. 2984-2985

Author(s):

Taihei Itoh ◽

Masaomi Kimura ◽

Kimitaka Nishizaki ◽

Hirofumi Tomita

Keyword(s):

Ventricular Tachycardia ◽

Grid Mapping ◽

Mapping Catheter

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Classification of Echocardiogram View using A Convolutional Neural Network

Artificial Intelligence Research ◽

10.5430/air.v11n1p1 ◽

2021 ◽

Vol 11 (1) ◽

pp. 1

Author(s):

Hannah Ornstein ◽

Dan Adam

Keyword(s):

Neural Network ◽

Convolutional Neural Network ◽

Papillary Muscle ◽

Short Axis ◽

Apical View ◽

Manual Classification ◽

Activation Mapping ◽

Axis View ◽

Papillary Muscle Level

The standard views in echocardiography capture distinct slices of the heart which can be used to assess cardiac function. Determining the view of a given echocardiogram is the first step for analysis. To automate this step, a deep network of the ResNet-18 architecture was used to classify between six standard views. The network parameters were pre-trained with the ImageNet database and prediction quality was assessed with a visualization tool known as gradient-weighted class activation mapping (Grad-CAM). The network was able to distinguish between three parasternal short axis views and three apical views to ~99\% accuracy. 10-fold cross validation showed a 97\%-98\% accuracy for the apical view subcategories (which included apical two-, three-, and four- chamber views). Grad-CAM images of these views highlighted features that were similar to those used by experts in manual classification. Parasternal short axis subcategories (which included apex level, mitral valve level, and papillary muscle level) had accuracies of 54\%-73\%. Grad-CAM images illustrate that the network classifies most parasternal short axis views as belonging to the papillary muscle level. Likely more images and incorporating time-dependent features would increase the parasternal short axis view accuracy. Overall, a convolutional neural network can be used to reliably classify echocardiogram views.

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Persistent atrial fibrillation originating from prominent Eustachian ridge: Precise identification of non-pulmonary vein foci using a high-density grid mapping catheter

HeartRhythm Case Reports ◽

10.1016/j.hrcr.2021.03.008 ◽

2021 ◽

Author(s):

Yasuteru Yamauchi ◽

Rena Nakamura ◽

Takatoshi Shigeta ◽

Yuichiro Sagawa ◽

Kaoru Okishige ◽

...

Keyword(s):

Atrial Fibrillation ◽

Pulmonary Vein ◽

Persistent Atrial Fibrillation ◽

High Density ◽

Precise Identification ◽

Grid Mapping ◽

Mapping Catheter

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Utility of novel Omnipolar activation mapping for the detection of ventricular premature contraction origin

European Heart Journal ◽

10.1093/ehjci/ehaa946.0415 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

S Maeda ◽

M Kawabata ◽

R Yonai ◽

Y Tsuda ◽

T Kawashima ◽

...

Keyword(s):

Catheter Ablation ◽

Ventricular Outflow Tract ◽

Lesion Size ◽

Bipolar Electrode ◽

Ventricular Premature Contraction ◽

Density Mapping ◽

Voltage Mapping ◽

Size Index ◽

Activation Mapping ◽

Mapping Catheter

Abstract Background Bipolar electrograms are significantly influenced by direction of the propagating wavefront in relation to the recording bipole. Omnipolar voltage mapping may be superior to standard bipolar mapping since it obtains maximum voltage of all possible bipolar electrode orientations without the need for catheter rotation. Therefore, omnipolar maps can provide voltage maps with larger voltages as well as better defined boundaries. Purpose Whether omnipolar activation maps also describe better activation maps versus traditional bipolar maps during ventricular premature contraction (VPC) catheter ablation is unclear. Methods A high-density mapping catheter was advanced to the ventricular outflow tract and a high-resolution activation map was created. Each electrode along and across the splines of the catheter are 4mm apart. Bipoles were calculated along (MAP 2), across (MAP 3) and bidirectional (MAP 4) the splines while omnipoles (MAP 1) were derived from a right triangle clique. Within a square area, four omnipolar and two bipolar values along, across and bidirectional values were defined. Results Though the earliest activation site was vague by along and across maps (arrow), white color became evident by bidirectional map, and the VPC origin became distinct with omnipolar mapping. RF lesions were given via an open-irrigated ablation catheter targeting a lesion size index 5.0. The VPC was eliminated by radiofrequency ablation. Conclusion Omnipolar activation mapping may be more accurate than traditional bipolar mapping during ventricular premature contraction (VPC) catheter ablation. Figure 1 Funding Acknowledgement Type of funding source: None

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Spatial Correction Improves Accuracy of Catheter Positioning During Ablation of Premature Ventricular Contractions: Differences Between Ventricular Outflow Tracts And Other Localizations.

10.21203/rs.3.rs-594511/v1 ◽

2021 ◽

Author(s):

Moritz Nies ◽

Ruben Schleberger ◽

Leon Dinshaw ◽

Niklas Klatt ◽

Paula Muenkler ◽

...

Keyword(s):

Ventricular Myocardium ◽

Outflow Tract ◽

Spatial Displacement ◽

Premature Ventricular Contractions ◽

Coupling Interval ◽

Improve Accuracy ◽

Radiofrequency Current ◽

Catheter Tip ◽

Activation Mapping ◽

Mapping Catheter

Abstract 1.1. PurposeHybrid activation mapping is a novel tool to correct for spatial displacement of the mapping catheter due to asymmetrical contraction of myocardium during premature ventricular contractions (PVC). The aim of this study is to describe the extent and cause of spatial displacement during PVC mapping and options for correction using hybrid activation mapping. 1.2. Methods and ResultsWe analyzed 5798 hybrid mapping points in 40 acquired hybrid maps of 22 consecutive patients (age 63±16 years, 45% female) treated for premature ventricular contractions (PVCs). Median PVC-coupling interval was 552 ms (IQR 83 ms). Spatial displacement was determined by measuring the dislocation of the catheter tip during PVC compared to the preceding sinus beat. Mean spatial displacement was 3.8±1.5 mm for all maps. The displacement was 1.3±0.4 mm larger for PVCs with non-outflow-tract origin compared to PVCs originating from the ventricular outflow tracts (RVOT/LVOT; p=0.028). Demographic parameters, PVC-coupling-interval and chamber of origin had no significant influence on the extent of spatial displacement. 1.3. ConclusionEctopic activation of the ventricular myocardium during PVCs results in spatial displacement of mapping points that is significantly larger for PVCs with non-outflow-tract origin. The correction for spatial displacement may improve accuracy of radiofrequency current (RFC)-application in catheter ablation of PVCs.

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