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Noninvasive Mapping of Premature Ventricular Contractions by Merging Magnetocardiography and Computed Tomography.
JACC Clin Electrophysiol 2019; 5(10):1144-1157JC

Abstract

OBJECTIVES

This study aimed to develop a novel premature ventricular contraction (PVC) mapping method to predict PVC origins in whole ventricles by merging a magnetocardiography (MCG) image with a cardiac computed tomography (CT) image.

BACKGROUND

MCG can noninvasively discriminate PVCs originating from the aortic sinus cusp from those originating from the right ventricular outflow tract.

METHODS

This study was composed of 22 candidates referred for catheter ablation of idiopathic PVCs. MCG and CT were performed the same day before ablation. Estimated origins by MCG-CT imaging using the recursive null steering spatial filter algorithm were compared with origins determined by electroanatomic mapping (CARTO, Biosense Webster, Inc., Diamond Bar, California) during the ablation procedure. Radiopaque acrylic markers for the CT scan and coil markers generating a weak magnetic field during MCG measurements were used as reference markers to merge the 2 images 3-dimensionally.

RESULTS

PVC origins were determined by endocardial and epicardial mapping and ablation results in 18 (86%) patients (right ventricular outflow tract in 10 patients, aortic sinus cusp in 2 patients, interventricular septum in 1 patient, near His bundle in 1 patient, right ventricular free wall in 1 patient, and left ventricular free wall in 3 patients). Estimated origins by MCG-CT imaging matched the origins determined during the procedure in 94% (17 of 18) of patients, whereas the electrocardiography algorithms were accurate in only 56% (10 of 18). Discrimination of an epicardium versus an endocardium or right- versus left-sided septum was successful in 3 of 4 patients (75%).

CONCLUSIONS

The diagnostic accuracy of noninvasive MCG-CT mapping was high enough to allow clinical use to predict the site of PVC origins in the whole ventricles.

Authors+Show Affiliations

Department of Cardiology, University of Tsukuba, Tsukuba, Japan.Research and Development Group, Hitachi Ltd., Kokubunji, Japan.Department of Cardiology, University of Tsukuba, Tsukuba, Japan; Department of Cardiology, Ibaraki Prefectural Central Hospital, Kasama, Japan. Electronic address: kentaroyo@nifty.com.Department of Cardiology, University of Tsukuba, Tsukuba, Japan.Department of Cardiology, University of Tsukuba, Tsukuba, Japan; Tsukuba Advanced Imaging Center, Tsukuba, Japan.Department of Cardiology, University of Tsukuba, Tsukuba, Japan.Department of Cardiology, University of Tsukuba, Tsukuba, Japan.Department of Cardiology, University of Tsukuba, Tsukuba, Japan.Department of Cardiology, University of Tsukuba, Tsukuba, Japan.Department of Cardiology, University of Tsukuba, Tsukuba, Japan.Signal Analysis Inc., Hachioji, Japan.Department of Pediatrics, University of Tsukuba, Tsukuba, Japan.Department of Cardiology, University of Tsukuba, Tsukuba, Japan.Department of Cardiology, University of Tsukuba, Tsukuba, Japan.Research and Development Group, Hitachi Ltd., Kokubunji, Japan.Department of Cardiology, University of Tsukuba, Tsukuba, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31648739

Citation

Aita, Satoshi, et al. "Noninvasive Mapping of Premature Ventricular Contractions By Merging Magnetocardiography and Computed Tomography." JACC. Clinical Electrophysiology, vol. 5, no. 10, 2019, pp. 1144-1157.
Aita S, Ogata K, Yoshida K, et al. Noninvasive Mapping of Premature Ventricular Contractions by Merging Magnetocardiography and Computed Tomography. JACC Clin Electrophysiol. 2019;5(10):1144-1157.
Aita, S., Ogata, K., Yoshida, K., Inaba, T., Kosuge, H., Machino, T., ... Ieda, M. (2019). Noninvasive Mapping of Premature Ventricular Contractions by Merging Magnetocardiography and Computed Tomography. JACC. Clinical Electrophysiology, 5(10), pp. 1144-1157. doi:10.1016/j.jacep.2019.06.010.
Aita S, et al. Noninvasive Mapping of Premature Ventricular Contractions By Merging Magnetocardiography and Computed Tomography. JACC Clin Electrophysiol. 2019;5(10):1144-1157. PubMed PMID: 31648739.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Noninvasive Mapping of Premature Ventricular Contractions by Merging Magnetocardiography and Computed Tomography. AU - Aita,Satoshi, AU - Ogata,Kuniomi, AU - Yoshida,Kentaro, AU - Inaba,Takeshi, AU - Kosuge,Hisanori, AU - Machino,Takeshi, AU - Tsumagari,Yasuaki, AU - Hattori,Ai, AU - Ito,Yoko, AU - Komatsu,Yuki, AU - Sekihara,Kensuke, AU - Horigome,Hitoshi, AU - Aonuma,Kazutaka, AU - Nogami,Akihiko, AU - Kandori,Akihiko, AU - Ieda,Masaki, Y1 - 2019/07/31/ PY - 2019/01/31/received PY - 2019/05/14/revised PY - 2019/06/19/accepted PY - 2019/10/26/entrez KW - catheter ablation KW - computed tomography KW - magnetocardiography KW - noninvasive mapping KW - premature ventricular contraction SP - 1144 EP - 1157 JF - JACC. Clinical electrophysiology JO - JACC Clin Electrophysiol VL - 5 IS - 10 N2 - OBJECTIVES: This study aimed to develop a novel premature ventricular contraction (PVC) mapping method to predict PVC origins in whole ventricles by merging a magnetocardiography (MCG) image with a cardiac computed tomography (CT) image. BACKGROUND: MCG can noninvasively discriminate PVCs originating from the aortic sinus cusp from those originating from the right ventricular outflow tract. METHODS: This study was composed of 22 candidates referred for catheter ablation of idiopathic PVCs. MCG and CT were performed the same day before ablation. Estimated origins by MCG-CT imaging using the recursive null steering spatial filter algorithm were compared with origins determined by electroanatomic mapping (CARTO, Biosense Webster, Inc., Diamond Bar, California) during the ablation procedure. Radiopaque acrylic markers for the CT scan and coil markers generating a weak magnetic field during MCG measurements were used as reference markers to merge the 2 images 3-dimensionally. RESULTS: PVC origins were determined by endocardial and epicardial mapping and ablation results in 18 (86%) patients (right ventricular outflow tract in 10 patients, aortic sinus cusp in 2 patients, interventricular septum in 1 patient, near His bundle in 1 patient, right ventricular free wall in 1 patient, and left ventricular free wall in 3 patients). Estimated origins by MCG-CT imaging matched the origins determined during the procedure in 94% (17 of 18) of patients, whereas the electrocardiography algorithms were accurate in only 56% (10 of 18). Discrimination of an epicardium versus an endocardium or right- versus left-sided septum was successful in 3 of 4 patients (75%). CONCLUSIONS: The diagnostic accuracy of noninvasive MCG-CT mapping was high enough to allow clinical use to predict the site of PVC origins in the whole ventricles. SN - 2405-5018 UR - https://www.unboundmedicine.com/medline/citation/31648739/Noninvasive_Mapping_of_Premature_Ventricular_Contractions_by_Merging_Magnetocardiography_and_Computed_Tomography L2 - https://linkinghub.elsevier.com/retrieve/pii/S2405-500X(19)30469-4 DB - PRIME DP - Unbound Medicine ER -