#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Spectral analysis of atrial components of ablation catheter signals during slow pathway ablation for typical atrioventricular nodal reentrant tachycardia


Ablation of the slow pathway is the treatment standard for typical atrioventricular nodal reentrant tachycardia (AVNRT). However, the risk of complete heart block due to ablation of the fast pathway remains approximately 1 %. Spectral analysis of the atrial components of ablation catheter signals during slow pathway ablation can provide additional information for precisely defining ablation sites. A retrospective study of the atrial components of 70 ablation catheter signals obtained from 20 patients was performed. Signals immediately prior to ablations were analyzed. The signals were divided into two groups: “good” (desired ablation answer) and “bad.” MATLAB software was used to analyze the signals. The amplitude spectrum received most attention. Afterwards, we compared similarities between “good” and “bad” signals from one patient using cross-correlation. The study population consisted of 20 patients. Each patient had one “good” signal and two or more “bad” signals. The mean frequency of the “good” signals was 13.37 ± 6.78 Hz and of the “bad” signals was 15.79 ± 6.82 Hz (p = n.s.). The relationship between “good” and “bad” signals was 0.73 ± 0.19. The amplitude spectrum of the atrial components of ablation catheter signals did not provide any useful differentiation for improving ablation accuracy.

Keywords:
AVNRT, spectral analysis, slow pathway


Autoři: Jana Žďárská 1,2;  Pavel Osmančík 1,2;  Ivona Hošková 1;  Dalibor Heřman 1;  Lukáš Kučera 3
Působiště autorů: Department of Arrhythmology, Third Internal Cardiology Clinic, Vinohrady Teaching Hospital, Prague, Czech Republic 1;  Third Faculty of Medicine, Charles University, Prague, Czech Republic 2;  Joint department of biomedical engineering CTU and First Faculty of Medicine Charles University, Prague, Czech Republic 3
Vyšlo v časopise: Lékař a technika - Clinician and Technology No. 4, 2015, 45, 115-121
Kategorie: Původní práce

Souhrn

Ablation of the slow pathway is the treatment standard for typical atrioventricular nodal reentrant tachycardia (AVNRT). However, the risk of complete heart block due to ablation of the fast pathway remains approximately 1 %. Spectral analysis of the atrial components of ablation catheter signals during slow pathway ablation can provide additional information for precisely defining ablation sites. A retrospective study of the atrial components of 70 ablation catheter signals obtained from 20 patients was performed. Signals immediately prior to ablations were analyzed. The signals were divided into two groups: “good” (desired ablation answer) and “bad.” MATLAB software was used to analyze the signals. The amplitude spectrum received most attention. Afterwards, we compared similarities between “good” and “bad” signals from one patient using cross-correlation. The study population consisted of 20 patients. Each patient had one “good” signal and two or more “bad” signals. The mean frequency of the “good” signals was 13.37 ± 6.78 Hz and of the “bad” signals was 15.79 ± 6.82 Hz (p = n.s.). The relationship between “good” and “bad” signals was 0.73 ± 0.19. The amplitude spectrum of the atrial components of ablation catheter signals did not provide any useful differentiation for improving ablation accuracy.

Keywords:
AVNRT, spectral analysis, slow pathway


Zdroje

[1] ISSA Z. F, J. M MILLER and D. P. ZIPES. Clinical arrhythmology and electrophysiology: a companion to Braunwald's heart disease. 2nd ed. Philadelphia, PA: Elseiver/Saunders, c2012, 726 p. ISBN 978-145-5712-748.

[2] CLAGUE, J., N. DAGRES, H. KOTTKAMP et al. Targeting the slow pathway for atrioventricular nodal reentrant tachycardia: initial results and long-term follow-up in 379 consecutive patients. European Heart Journal. 2001;22;1;82-88. DOI:

10.1053/euhj. 2000. 2124. www: http://eurheartj.oxfordjournals.org/cgi/doi/10.1053/euhj.2000.2124

[3] HUANG, S. K. S. a M. WOOD. Catheter ablation of cardiac arrhythmias. 1st ed. Editor Shoei K Huang, Mark A Wood. Philadelphia, PA: Saunders Elsevier, c2006, 691 p. ISBN 978-141-6003-120.

[4] NIKOO M. H., Z. EMKANJOO et al. Can successful radiofrequency ablation of atrioventricular nodal reentrant tachycardia be predicted by pattern of junctional ectopy?. Journal of Electrocardiology. 2008; 41; 1; 39-43. DOI: 10. 1016/j.electrocard.2007.07.005.

www: http://linkinghub.elsevier.com/retrieve/pii/S0022073607006772

[5] JACKMAN W. M., K. J. BECKMAN, J. H. MCCLELLAND et al. Treatment of Supraventricular Tachycardia Due to Atrioventricular Nodal Reentry by Radiofrequency Catheter Ablation of Slow-Pathway Conduction. New England Journal of Medicine. 1992;327;5;313-318. DOI: 10.1056/NEJM199207303270504.

www: http://www.nejm.org/doi/abs/10.1056/NEJM199207303270504

[6] HAISSAGUERRE M., F. GAITA, B. FISCHER et al. Elimination of atrioventricular nodal reentrant tachycardia using discrete slow potentials to guide application of radiofrequency energy. Circulation. 1992;85; 6; 2162-2175. DOI: 10.1161/01.CIR.85.6.2162.

www: http://circ.ahajournals.org/cgi/doi/10.1161/01.CIR.85.6.2162

[7] DELISE P., A. BONSO, L. CORO et al. Pacemapping of the Triangle of Koch: A Simple Method to Reduce the Risk of Atrioventricular Block During Radiofrequency Ablation of Atrioventricular Node Reentrant Tachycardia. Pacing and Clinical Electrophysiology. 2001;24;12;1725-1731. DOI: 10.1046/j.1460-9592.2001.01725.x.

www: http://doi.wiley.com/10.1046/j.1460-9592.2001.01725.x

[8] HIRAO H, Y. MURAOKA, T. YAMAGATA et al. Comparison of properties of slow pathway potential between successful and unsuccessful radiofrequency applications in patients who underwent catheter ablation for atrioventricular nodal reentrant tachycardia. Hiroshima J Med Sci. 2000; 49(1):15-27. PubMed PMID: 10824453.

[9] ENJOJI Y., K. SUGI, T. IKEDA et al. A Simple Technique for Anatomical Slow Pathway Ablation in Atrioventricular Nodal Reentrant Tachycardia. Japanese Heart Journal. 1999;40;5;561-569. DOI: 10.1536/jhj.40.561.

www: http://joi.jlc.jst.go.jp/JST.JSTAGE/jhj/40.561?from=CrossRef

[10] NIGRO G., V. RUSSO, A. RAGO et al. Which parameters describe the electrophysiological properties of successful slow pathway RF ablation in patients with common atrioventricular nodal reentrant tachycardia?. Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology. 2010-04-08;10;2;126-129. DOI: 10.5152/akd.2010.036.

www: http://www.anakarder.com/eng/makale/1839/69/Full-Text

[11] HAYASHI M., Y. KOBAYASHI, Y. MIYAUCHI et al. A Randomized Comparison of the Straight Linear Approach with Electrogram Mapping Focal Approach in Selective Slow Pathway Ablation. Pacing and Clinical Electrophysiology. 2001, vol. 24, issue 8, p. 1187-1197. DOI: 10.1046/j.1460-9592.2001.01187.x. www: http://doi.wiley.com/10.1046/j.1460-9592.2001.01187.x.

[12] CHIYODA K., Y. KOBAYASHI, Y. JINBO et al. Selective slow pathway ablation in atrioventricular nodal reentrant tachycardia: Comparison of different methods and the site of slow pathway ablation. Japanese Circulation Journal. 1996; 60; 861-870.

[13] FEMENÍA F., M. ARCE, M. ARRIETA et al. Long-term results of slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia: simple approach. Journal of Electrocardiology. 2012; 45; 3; 203-208. DOI: 10.1016/j.jelectrocard.2011.12.007.

www: http://linkinghub.elsevier.com/retrieve/pii/S0022073611005218

[14] KOPELMAN H., S. P. PRATER, F. TONDATO et al. Slow pathway catheter ablation of atrioventricular nodal re-entrant tachycardia guided by electroanatomical mapping: a randomized comparison to the conventional approach. Europace. 2003;5;2;171-174. DOI: 10.1053/eupc.2002.0296. www: http://europace.oxfordjournals.org/cgi/doi/10.1053/eupc.2002.0296

Štítky
Biomedicína
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#