Author + information
- Received February 12, 2020
- Revision received May 20, 2020
- Accepted May 20, 2020
- Published online August 12, 2020.
- Deepak Saluja, MDa,∗ (, )
- Tal Bar-on, BAb,
- Gal Hayam, BAb,
- John Kassotis, MD, EngSciDc,
- William J. Kostis, PhD, MDc and
- James Coromilas, MDc
- aDepartment of Medicine, Columbia University, New York, New York
- bBiosense Webster, Yokneam, Israel
- cDepartment of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey
- ↵∗Address for correspondence:
Dr. Deepak Saluja, Columbia University, Vagelos College of Physicians and Surgeons, 622 West 168th Street, New York, New York, New York 10032.
Objectives This study assessed the accuracy of an algorithm that predicts the origin of focal arrhythmias using a limited number of data points.
Background Despite advances in technology, ablations can be time-consuming, and activation mapping continues to have inherent limitations. The authors developed an algorithm that can predict the origin of a focal wavefront using the location and activation timing information in 2 pairs of sampled points. This algorithm was incorporated into an electroanatomic mapping (EAM) system to assess its accuracy in a 3-dimensional clinical environment.
Methods EAM data from patients who underwent successful ablation of a focal wavefront using the CARTO3 system were loaded onto an offline version of the software modified to contain the algorithm. Prediction curves were retrospectively generated. Predictive accuracy, defined as the distance between true and predicted origin wavefront origins, was measured.
Results Seventeen wavefronts in as many patients (2 with atrial tachycardia, 3 with orthodromic re-entrant tachycardia, 8 with premature ventricular complex and/or ventricular tachycardia, 4 with focal pulmonary vein isolation breakthroughs) were studied. Thirty-three origin predictions were attempted (1.9 ± 0.4 per patient) using 132 points. Predictions were successfully calculated in 31 of 33 (93.9%) attempts and were accurate to within 5.7 ± 6.9 mm. Individual prediction curves were accurate to within 3.0 ± 4.7 mm.
Conclusions Focal wavefront origins may be accurately predicted in 3 dimensions using a novel algorithm incorporated into an EAM system.
This work was supported by research funding from Biosense Webster. Dr. Saluja is a patent holder (through Rutgers University) of the background technology used in this research. Mr. Bar-on and Mr. Hayam are enployees of Biosense Webster. Dr. Coromilas has been a consultant for DRF and Abbott; and has been a member of the Clinic Events Committee for Abbott. 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 February 12, 2020.
- Revision received May 20, 2020.
- Accepted May 20, 2020.
- 2020 American College of Cardiology Foundation
This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click Login or the Subscribe link (top menu above) to access this article.