Key result
Noncontact endocardial mapping correlated with epicardial mapping for activation times (r=0.80 and 0.63 in two dogs) and area under the atrial T wave (r=0.57 and 0.46), demonstrating its ability to extract atrial repolarization information.
Effect estimate: r=0.80 and 0.63
p-value: p=<0.001
Noncontact endocardial mapping retains relevant information about atrial repolarization and correlates with epicardial mapping in canine models.
Supports preclinical validation of noncontact mapping for atrial repolarization; leaves open human translation and clinical adoption.
Epicardial high-density electrical mapping is a well-established experimental instrument to monitor in vivo the activity of the atria in response to modulations of the autonomic nervous system in sinus rhythm. In regions that are not accessible by epicardial mapping, noncontact endocardial mapping performed through a balloon catheter may provide a more comprehensive description of atrial activity. We developed a computer model of the canine right atrium to compare epicardial and noncontact endocardial mapping. The model was derived from an experiment in which electroanatomical reconstruction, epicardial mapping (103 electrodes), noncontact endocardial mapping (2048 virtual electrodes computed from a 64-channel balloon catheter), and direct-contact endocardial catheter recordings were simultaneously performed in a dog. The recording system was simulated in the computer model. For simulations and experiments (after atrio-ventricular node suppression), activation maps were computed during sinus rhythm. Repolarization was assessed by measuring the area under the atrial T wave (ATa), a marker of repolarization gradients. Results showed an epicardial-endocardial correlation coefficients of 0.80 and 0.63 (two dog experiments) and 0.96 (simulation) between activation times, and a correlation coefficients of 0.57 and 0.46 (two dog experiments) and 0.92 (simulation) between ATa values. Despite distance (balloon-atrial wall) and dimension reduction (64 electrodes), some information about atrial repolarization remained present in noncontact signals.
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Sabouri et al. (2014) studied Structurally normal heart (canine right atrium) (n=2). Noncontact endocardial mapping vs. Epicardial mapping was evaluated on Correlation coefficient between epicardial and endocardial activation times (r=0.80 and 0.63, p=<0.001). Noncontact endocardial mapping correlated with epicardial mapping for activation times (r=0.80 and 0.63 in two dogs) and area under the atrial T wave (r=0.57 and 0.46), demonstrating its ability to extract atrial repolarization information.
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