Author + information
- Received November 6, 2018
- Revision received January 8, 2019
- Accepted January 17, 2019
- Published online April 15, 2019.
- Claire A. Martin, PhDa,b,c,d,∗ (, )
- Masateru Takigawa, PhDa,b,c,
- Ruairidh Martin, MPhila,b,c,e,
- Philippe Maury, MDf,
- Christian Meyer, MDg,
- Tom Wong, MDh,
- Rui Shi, MDh,
- Parag Gajendragadkar, MPhild,
- Antonio Frontera, PhDa,b,c,
- Ghassen Cheniti, MDa,b,c,
- Nathaniel Thompson, MDa,b,c,
- Takeshi Kitamura, MDa,b,c,
- Konstantinos Vlachos, MDa,b,c,
- Michael Wolf, MDa,b,c,
- Felix Bourier, MDa,b,c,
- Anna Lam, MDa,b,c,
- Josselin Duchâteau, PhDa,b,c,
- Grégoire Massoullié, MDa,b,c,
- Thomas Pambrun, MDa,b,c,
- Arnaud Denis, MDa,b,c,
- Nicolas Derval, MDa,b,c,
- Mélèze Hocini, MDa,b,c,
- Michel Haïssaguerre, MDa,b,c,
- Pierre Jaïs, MDa,b,c and
- Frédéric Sacher, PhDa,b,c
- aElectrophysiology and Ablation Unit, Bordeaux University Hospital (Centre Hospitalier Universitaire [CHU]), Pessac, France
- bInstitut Hospitalo-Universitaire (IHU), LIRYC, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac- Bordeaux, France
- cUniversité Bordeaux, Institut National de la Santé et de la Recherche Médicale U1045, Bordeaux, France
- dDepartment of Electrophysiology, Royal Papworth Hospital National Health Service Foundation Trust, Cambridge, United Kingdom
- eDepartment of Cardiology, Newcastle University, Newcastle, United Kingdom
- fUnité Inserm U 1048, University Hospital Rangueil, Toulouse, France
- gDepartment of Cardiology, University Medical Center Hamburg—Eppendorf, Hamburg, Germany
- hDepartment of Electrophysiology, Brompton Hospital, London, United Kingdom
- ↵∗Address for correspondence:
Dr. Claire A. Martin, IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-/ Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit/Université Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000, Bordeaux, France/ 33600 Pessac-Bordeaux, France.
Objectives This study reports the use of a novel “Lumipoint” algorithm in ventricular tachycardia (VT) ablation.
Background Automatic mapping systems aid rapid acquisition of activation maps. However, they may annotate farfield rather than nearfield signal in low voltage areas, making maps difficult to interpret. The Lumipoint algorithm analyzes the complete electrogram tracing and therefore includes nearfield signals in its analysis.
Methods Twenty-two patients with ischemic cardiomyopathy and 5 with dilated cardiomyopathy underwent mapping using the ultra-high density Rhythmia system. Lumipoint algorithms were applied retrospectively.
Results In all left ventricular substrate maps, changing the window of interest to the post-QRS phase automatically identified late potentials. In 25 of 27 left ventricular VT activation maps, a minimum spatial window of interest correctly identified the VT isthmus as seen by the manually annotated map, entrainment, and response to ablation. In 6 maps, the algorithm identified the isthmus where the standard automatically annotated map did not.
Conclusions The Lumipoint algorithm automatically highlights areas with electrograms having specific characteristics or timings. This can identify late and fractionated potentials and regions that exhibit discontinuous activation, as well as the isthmus of a VT circuit. These features may enhance human interpretation of the electrogram signals during a case, particularly where the circuit lies in partial scar with low amplitude nearfield signals and potentially allow a more targeted ablation strategy.
This research was supported by IHU LIRYC grant ANR-10-IAHU-04. Dr. Meyer has received speaking honoraria from Boston Scientific and Abbott; and has served on the advisory board of Biosense Webster. Drs. Derval, Denis, Jaïs, and Sacher, have received modest consulting fees and speaking honoraria from Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
All 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 November 6, 2018.
- Revision received January 8, 2019.
- Accepted January 17, 2019.
- 2019 American College of Cardiology Foundation
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