Spatial resolution and role of pacemapping during ablation of accessory pathways.
Identifieur interne : 001735 ( PubMed/Checkpoint ); précédent : 001734; suivant : 001736Spatial resolution and role of pacemapping during ablation of accessory pathways.
Auteurs : F. Molin [Canada] ; P. Savard ; M. Dubuc ; T. Kus ; G. Tremblay ; R. NadeauSource :
- Pacing and clinical electrophysiology : PACE [ 0147-8389 ] ; 1997.
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Abstract
The objectives of this study were: (1) to evaluate quantitatively the spatial resolution of pacemapping; and (2) to assess the predictive value and role of pacemapping for the catheter ablation of overt APs. Sixty-three unipolar leads were used instead of the standard 12-lead ECG to acquire more information and assess the intrinsic accuracy of pacemapping. Spatial resolution was evaluated in 19 patients for whom data were recorded during bipolar ventricular pacing near the AV ring using the three electrode pairs of a quadripolar ablation catheter with a 5-mm interelectrode spacing. The predictive value was assessed in 27 patients with overt APs who underwent RF ablation; their data were recorded during pacing at the site of successful ablation and at one or two sites where RF energy delivery was ineffective. Data from different beats were compared visually by using body surface potential maps and quantitatively by computing average correlation coefficients (r). Reproducibility was high for paced beats (r = 0.98 +/- 0.02). Displacements of 5 mm of the pacing site could be detected with a sensitivity of 90% and a specificity of 87%. Correlation between pacing at successful ablation sites and preexcited sinus rhythm was low (r = 0.79 +/- 0.11) and the ablation outcome could be predicted with a negative prediction accuracy of 87% and a positive prediction accuracy of 49%. Despite an excellent spatial resolution, pacemapping is of limited value for the identification of successful AP ablation sites, probably because APs can be interrupted at some distance from their ventricular insertion point.
PubMed: 9080495
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Spatial resolution and role of pacemapping during ablation of accessory pathways.</title><author><name sortKey="Molin, F" sort="Molin, F" uniqKey="Molin F" first="F" last="Molin">F. Molin</name><affiliation wicri:level="1"><nlm:affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Québec, Canada. molinf@ere.umontreal.ca</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Research Center, Hôpital du Sacré-Coeur de Montréal, Québec</wicri:regionArea><wicri:noRegion>Québec</wicri:noRegion></affiliation></author><author><name sortKey="Savard, P" sort="Savard, P" uniqKey="Savard P" first="P" last="Savard">P. Savard</name></author><author><name sortKey="Dubuc, M" sort="Dubuc, M" uniqKey="Dubuc M" first="M" last="Dubuc">M. Dubuc</name></author><author><name sortKey="Kus, T" sort="Kus, T" uniqKey="Kus T" first="T" last="Kus">T. Kus</name></author><author><name sortKey="Tremblay, G" sort="Tremblay, G" uniqKey="Tremblay G" first="G" last="Tremblay">G. Tremblay</name></author><author><name sortKey="Nadeau, R" sort="Nadeau, R" uniqKey="Nadeau R" first="R" last="Nadeau">R. Nadeau</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1997">1997</date><idno type="RBID">pubmed:9080495</idno><idno type="pmid">9080495</idno><idno type="wicri:Area/PubMed/Corpus">001837</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001837</idno><idno type="wicri:Area/PubMed/Curation">001837</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001837</idno><idno type="wicri:Area/PubMed/Checkpoint">001837</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001837</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Spatial resolution and role of pacemapping during ablation of accessory pathways.</title><author><name sortKey="Molin, F" sort="Molin, F" uniqKey="Molin F" first="F" last="Molin">F. Molin</name><affiliation wicri:level="1"><nlm:affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Québec, Canada. molinf@ere.umontreal.ca</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Research Center, Hôpital du Sacré-Coeur de Montréal, Québec</wicri:regionArea><wicri:noRegion>Québec</wicri:noRegion></affiliation></author><author><name sortKey="Savard, P" sort="Savard, P" uniqKey="Savard P" first="P" last="Savard">P. Savard</name></author><author><name sortKey="Dubuc, M" sort="Dubuc, M" uniqKey="Dubuc M" first="M" last="Dubuc">M. Dubuc</name></author><author><name sortKey="Kus, T" sort="Kus, T" uniqKey="Kus T" first="T" last="Kus">T. Kus</name></author><author><name sortKey="Tremblay, G" sort="Tremblay, G" uniqKey="Tremblay G" first="G" last="Tremblay">G. Tremblay</name></author><author><name sortKey="Nadeau, R" sort="Nadeau, R" uniqKey="Nadeau R" first="R" last="Nadeau">R. Nadeau</name></author></analytic><series><title level="j">Pacing and clinical electrophysiology : PACE</title><idno type="ISSN">0147-8389</idno><imprint><date when="1997" type="published">1997</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Body Surface Potential Mapping</term><term>Cardiac Pacing, Artificial</term><term>Catheter Ablation</term><term>Female</term><term>Heart Conduction System (surgery)</term><term>Humans</term><term>Male</term><term>ROC Curve</term><term>Reproducibility of Results</term><term>Wolff-Parkinson-White Syndrome (physiopathology)</term><term>Wolff-Parkinson-White Syndrome (surgery)</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Heart Conduction System</term><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Body Surface Potential Mapping</term><term>Cardiac Pacing, Artificial</term><term>Catheter Ablation</term><term>Female</term><term>Humans</term><term>Male</term><term>ROC Curve</term><term>Reproducibility of Results</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The objectives of this study were: (1) to evaluate quantitatively the spatial resolution of pacemapping; and (2) to assess the predictive value and role of pacemapping for the catheter ablation of overt APs. Sixty-three unipolar leads were used instead of the standard 12-lead ECG to acquire more information and assess the intrinsic accuracy of pacemapping. Spatial resolution was evaluated in 19 patients for whom data were recorded during bipolar ventricular pacing near the AV ring using the three electrode pairs of a quadripolar ablation catheter with a 5-mm interelectrode spacing. The predictive value was assessed in 27 patients with overt APs who underwent RF ablation; their data were recorded during pacing at the site of successful ablation and at one or two sites where RF energy delivery was ineffective. Data from different beats were compared visually by using body surface potential maps and quantitatively by computing average correlation coefficients (r). Reproducibility was high for paced beats (r = 0.98 +/- 0.02). Displacements of 5 mm of the pacing site could be detected with a sensitivity of 90% and a specificity of 87%. Correlation between pacing at successful ablation sites and preexcited sinus rhythm was low (r = 0.79 +/- 0.11) and the ablation outcome could be predicted with a negative prediction accuracy of 87% and a positive prediction accuracy of 49%. Despite an excellent spatial resolution, pacemapping is of limited value for the identification of successful AP ablation sites, probably because APs can be interrupted at some distance from their ventricular insertion point.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">9080495</PMID><DateCreated><Year>1997</Year><Month>06</Month><Day>02</Day></DateCreated><DateCompleted><Year>1997</Year><Month>06</Month><Day>02</Day></DateCompleted><DateRevised><Year>2006</Year><Month>11</Month><Day>15</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0147-8389</ISSN><JournalIssue CitedMedium="Print"><Volume>20</Volume><Issue>3 Pt 1</Issue><PubDate><Year>1997</Year><Month>Mar</Month></PubDate></JournalIssue><Title>Pacing and clinical electrophysiology : PACE</Title><ISOAbbreviation>Pacing Clin Electrophysiol</ISOAbbreviation></Journal><ArticleTitle>Spatial resolution and role of pacemapping during ablation of accessory pathways.</ArticleTitle><Pagination><MedlinePgn>683-94</MedlinePgn></Pagination><Abstract><AbstractText>The objectives of this study were: (1) to evaluate quantitatively the spatial resolution of pacemapping; and (2) to assess the predictive value and role of pacemapping for the catheter ablation of overt APs. Sixty-three unipolar leads were used instead of the standard 12-lead ECG to acquire more information and assess the intrinsic accuracy of pacemapping. Spatial resolution was evaluated in 19 patients for whom data were recorded during bipolar ventricular pacing near the AV ring using the three electrode pairs of a quadripolar ablation catheter with a 5-mm interelectrode spacing. The predictive value was assessed in 27 patients with overt APs who underwent RF ablation; their data were recorded during pacing at the site of successful ablation and at one or two sites where RF energy delivery was ineffective. Data from different beats were compared visually by using body surface potential maps and quantitatively by computing average correlation coefficients (r). Reproducibility was high for paced beats (r = 0.98 +/- 0.02). Displacements of 5 mm of the pacing site could be detected with a sensitivity of 90% and a specificity of 87%. Correlation between pacing at successful ablation sites and preexcited sinus rhythm was low (r = 0.79 +/- 0.11) and the ablation outcome could be predicted with a negative prediction accuracy of 87% and a positive prediction accuracy of 49%. Despite an excellent spatial resolution, pacemapping is of limited value for the identification of successful AP ablation sites, probably because APs can be interrupted at some distance from their ventricular insertion point.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Molin</LastName><ForeName>F</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Research Center, Hôpital du Sacré-Coeur de Montréal, Québec, Canada. molinf@ere.umontreal.ca</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Savard</LastName><ForeName>P</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Dubuc</LastName><ForeName>M</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Kus</LastName><ForeName>T</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Tremblay</LastName><ForeName>G</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Nadeau</LastName><ForeName>R</ForeName><Initials>R</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Pacing Clin Electrophysiol</MedlineTA><NlmUniqueID>7803944</NlmUniqueID><ISSNLinking>0147-8389</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018780" MajorTopicYN="N">Body Surface Potential Mapping</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002304" MajorTopicYN="Y">Cardiac Pacing, Artificial</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017115" MajorTopicYN="Y">Catheter Ablation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006329" MajorTopicYN="N">Heart Conduction System</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012372" MajorTopicYN="N">ROC Curve</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015203" MajorTopicYN="N">Reproducibility of Results</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014927" MajorTopicYN="N">Wolff-Parkinson-White Syndrome</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1997</Year><Month>3</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1997</Year><Month>3</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1997</Year><Month>3</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">9080495</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Canada</li></country></list><tree><noCountry><name sortKey="Dubuc, M" sort="Dubuc, M" uniqKey="Dubuc M" first="M" last="Dubuc">M. Dubuc</name><name sortKey="Kus, T" sort="Kus, T" uniqKey="Kus T" first="T" last="Kus">T. Kus</name><name sortKey="Nadeau, R" sort="Nadeau, R" uniqKey="Nadeau R" first="R" last="Nadeau">R. Nadeau</name><name sortKey="Savard, P" sort="Savard, P" uniqKey="Savard P" first="P" last="Savard">P. Savard</name><name sortKey="Tremblay, G" sort="Tremblay, G" uniqKey="Tremblay G" first="G" last="Tremblay">G. Tremblay</name></noCountry><country name="Canada"><noRegion><name sortKey="Molin, F" sort="Molin, F" uniqKey="Molin F" first="F" last="Molin">F. Molin</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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