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40/Three-dimensional 12-lead ECG-based electrocardiographic imaging in cardiac resynchronisation therapy recipients – Validation against non-contact electroanatomical mapping

Published Online: October 4th 2008 European Journal of Arrhythmia & Electrophysiology. 2019;5(Suppl. 1):abstr40
Authors: O Okafor (Presenting Author) – Aston University, Birmingham, UK; F Umar – University of Birmingham, Birmingham, UK; P M van Dam – University Medical Centre, Utrecht, The Netherlands; J Walton – Queen Elizabeth Hospital, Birmingham, UK; B Stegemann – Aston University, Birmingham, UK; A Zegard – Aston University, Birmingham, UK; M Kalla – Queen Elizabeth Hospital, Birmingham, UK; M Lencioni – Queen Elizabeth Hospital, Birmingham, UK; J de Bono – Queen Elizabeth Hospital, Birmingham, UK; H Marshall – Queen Elizabeth Hospital, Birmingham, UK; T Qiu – Queen Elizabeth Hospital, Birmingham, UK; Leyva – Aston University, Birmingham, UK
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Background: The cardiac isochrone positioning system (CIPS) is a novel electrocardiographic imaging (ECGi) modality that integrates 12-lead ECG, body surface imaging and cardiac magnetic resonance (CMR).

Objective: To validate CIPS against non-contact electroanatomical mapping (EAM) with respect to left ventricular (LV) activation patterns in patients undergoing cardiac resynchronisation therapy (CRT).

Methods: CRT recipients (n=16; LBBB in 12, nonspecific intraventricular conduction delay [NICD] in 4) underwent ECGi (CIPS) and EAM (Ensite, Abbott) during intrinsic and right ventricular (RV) pacing. Three independent electrophysiologists were asked to score the accuracy of early and late LV activation using CIPS against EAM (62 maps).

Results: The latest activated segment on EAM were lateral, posterior or anterior LV segments (50%, 44% and 6%, respectively). Using expert adjudication, CIPS correctly identified late LV activation during intrinsic rhythm in 13/16 (81.3%) patients (kappa coefficient: 0.88 (95% confidence intervals [CI]: 0.73–1, p<0.0001). In RV-paced rhythms, CIPS accurately identified early (95.6%) and late (97.8%) activation (kappa coefficients 0.91 (95% confidence intervals [CI] 0.78–1.00); 0.96 [95% 0.86–1.00], respectively).

Conclusion: CIPS, which is based on a 12-lead ECG, reliably identifies LV activation patterns compared to EAM. This has implications for tailoring LV lead deployment and vector selection during CRT.

 

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European Journal of Arrhythmia & Electrophysiology. 2021;7(Suppl. 1):abstr43

Introduction: Cardiac tamponade is a high morbidity complication of transseptal puncture (TSP). We examined the incidence and predictors of TSP-related cardiac tamponade (TRCT) for all patients undergoing left atrial ablation at our centre from 2016-2020. Methods: Patient and procedural variables were extracted retrospectively. Cases of cardiac tamponade were scrutinised to adjudicate TSP culpability. Adjusted multivariate […]

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