An automated 12-lead ECG-based system for localizing the site of origin of left ventricular activation in scar-related VT achieved an estimated accuracy within 10 mm.
Observational (n=19)
Does an automated intraprocedural 12-lead ECG-based system accurately localize early left ventricular activation in patients undergoing ablation for scar-related VT?
An automated 12-lead ECG-based localization system can accurately identify the site of origin of left ventricular activation within 10 mm during VT ablation.
BACKGROUND: To facilitate ablation of ventricular tachycardia (VT), an automated localization system to identify the site of origin of left ventricular activation in real time using the 12-lead ECG was developed. The objective of this study was to prospectively assess its accuracy. METHODS: The automated site of origin localization system consists of 3 steps: (1) localization of ventricular segment based on population templates, (2) population-based localization within a segment, and (3) patient-specific site localization. Localization error was assessed by the distance between the known reference site and the estimated site. RESULTS: In 19 patients undergoing 21 catheter ablation procedures of scar-related VT, site of origin localization accuracy was estimated using 552 left ventricular endocardial pacing sites pooled together and 25 VT-exit sites identified by contact mapping. For the 25 VT-exit sites, localization error of the population-based localization steps was within 10 mm. Patient-specific site localization achieved accuracy of within 3.5 mm after including up to 11 pacing (training) sites. Using 3 remotes (67.8±17.0 mm from the reference VT-exit site), and then 5 close pacing sites, resulted in localization error of 7.2±4.1 mm for the 25 identified VT-exit sites. In 2 emulated clinical procedure with 2 induced VTs, the site of origin localization system achieved accuracy within 4 mm. CONCLUSIONS: In this prospective validation study, the automated localization system achieved estimated accuracy within 10 mm and could thus provide clinical utility.
Zhou et al. (Mon,) conducted a observational in Scar-related ventricular tachycardia (n=19). Automated intraprocedural 12-lead ECG-based localization system vs. Contact mapping (known reference site) was evaluated on Localization error (distance between the known reference site and the estimated site). An automated 12-lead ECG-based system for localizing the site of origin of left ventricular activation in scar-related VT achieved an estimated accuracy within 10 mm.