Author + information
- Received January 31, 2019
- Revision received May 14, 2019
- Accepted June 19, 2019
- Published online October 21, 2019.
- Satoshi Aita, MDa,∗,
- Kuniomi Ogata, MEngb,∗,
- Kentaro Yoshida, MDa,c,∗ (, )
- Takeshi Inaba, RDCSa,
- Hisanori Kosuge, MDa,d,
- Takeshi Machino, MDa,
- Yasuaki Tsumagari, MDa,
- Ai Hattori, MDa,
- Yoko Ito, MDa,
- Yuki Komatsu, MDa,
- Kensuke Sekihara, PhDe,
- Hitoshi Horigome, MDf,
- Kazutaka Aonuma, MDa,
- Akihiko Nogami, MDa,
- Akihiko Kandori, PhDb,† and
- Masaki Ieda, MDa,†
- aDepartment of Cardiology, University of Tsukuba, Tsukuba, Japan
- bResearch and Development Group, Hitachi Ltd., Kokubunji, Japan
- cDepartment of Cardiology, Ibaraki Prefectural Central Hospital, Kasama, Japan
- dTsukuba Advanced Imaging Center, Tsukuba, Japan
- eSignal Analysis Inc., Hachioji, Japan
- fDepartment of Pediatrics, University of Tsukuba, Tsukuba, Japan
- ↵∗Address for correspondence:
Dr. Kentaro Yoshida, Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan.
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.
- catheter ablation
- computed tomography
- noninvasive mapping
- premature ventricular contraction
↵∗ Drs. Aita and Ogata contributed equally to this work and are joint first authors.
↵† Drs. Kandori and Ieda contributed equally to this work and are joint senior authors.
This work was supported by JPS KAKENHI grant number JP17K09484. Dr. Aonuma has received a research grant from Hitachi, Ltd. Dr. Nogami has received honoraria from Abbott; and has received an endowment from Medtronic and Johnson and Johnson. Mr. Ogata holds the patent JP6393173B, position estimation method, and position estimation system. Dr. Kandori holds the patent JP6393173B, positional estimation method and positional estimation system. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received January 31, 2019.
- Revision received May 14, 2019.
- Accepted June 19, 2019.
- 2019 The Authors