AI Article Synopsis
- The study aimed to find out the minimum number of ECGI leads necessary for achieving good spatial resolution in mapping arrhythmias during ablation procedures.
- Out of 20 patients, the highest agreement between ECGI and Carto mapping was when using 23 electrode bands (85% agree rate), while reducing to 6 electrode bands significantly decreased agreement to 55%.
- The findings suggest that while fewer leads lead to lower spatial resolution, approximately 74 leads are sufficient for acceptable quality mapping, indicating efficiency in lead usage can be achieved without compromising accuracy.
Article Abstract
Aims: Assess the minimal number of ECGI leads needed to obtain a good spatial resolution.
Methods: We enrolled 20 patients that underwent ablation of premature ventricular or atrial contractions using Carto and ECGI with AMYCARD. We evaluated the agreement regarding the site of origin of the arrhythmia between the ECGI and Carto, the area and diameter of the earliest activation site obtained with the ECGI (EASa and EASd). Based on previous studies with pacemapping, we considered a good spatial resolution of the ECGI when the EASd measured on the isopotential map was less than 18 mm. In presence of agreement the ECGI was reprocessed: a) with half the number of electrode bands (8 leads per electrode band) and b) with 6 electrode bands.
Results: The initial map was obtained with 23 (22-23) electrode bands per patient, corresponding to 143 (130-170) leads. Agreement rate was 85%, the median EASa and EASd were: 0.7 (0.5-1.3) cm and 9 (8-13) mm. With half the number of electrode bands including 73 (60-79) leads, agreement rate was 80%, the EASa and EASd were: 2.1 (1.5-6.2) cm and 16 (14 -28) mm. With only six electrode bands using 38 (30-42) leads, agreement rate was 55%, EASa and EASd were: 4.0 (3.3-5.0) cm and 23 (21-25) mm. The number of leads was a predictor of agreement with a good spatial resolution, OR (95% CI) of 1.138 (1.050-1.234), p = .002. According to the ROC curve, the minimal number of leads was 74 (AUC 0.981; 95% CI: 0.949-1.00, p < .0001).
Conclusion: Reducing the number of leads was associated with a lower agreement rate and a significant reduction of spatial resolution. However, the number of leads needed to achieve a good spatial resolution was less than the maximal available.
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| http://dx.doi.org/10.1016/j.jelectrocard.2020.07.004 | DOI Listing |
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