Key result
A modified CARTO pattern matching method using intracardiac electrograms successfully identified the origin of premature atrial complexes in two patients, facilitating targeted catheter ablation.
Why the study?
Applying CARTO Pattern matching to premature atrial complexes could improve ablation efficiency, but standard methods cannot automatically detect the site of origin due to low P-wave amplitude, short duration, and T-wave fusion.
Case Report (n=2)
No
A modified CARTO pattern matching method incorporating intracardiac potentials enables automatic identification of premature atrial contraction origins for ablation.
May aid APC origin localization during ablation; leaves open prospective validation of efficiency gains.
三次元マッピング装置であるCARTO3® systemに搭載されたPattern matching機能は，治療対象の心室期外収縮とリアルタイムで得られた12誘導心電図QRS波形の相関が高い箇所を画面上に表示するアブレーション支援プログラムである．心房期外収縮の起源同定にPattern matching機能を応用することで高周波通電部位の視認性が高まり，術時間の短縮や治療効果の改善が見込まれる．しかし，P波はQRS波に比べて波高が低く持続時間が短いことや，先行拍のT波と融合することがあるため，本法をそのまま流用してもP波の発生部位を自動検出することはできない．今回，われわれは胸部誘導（V1，V6誘導）に加えて，高位右房と冠静脈洞の心内電位を用いたPattern matching法を考案して，心房期外収縮の起源を自動的に同定するとともにアブレーションを行った2例を報告する．
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Fujioka et al. (2023) conducted a case report in Premature atrial complex (PAC) (n=2). Modified CARTO pattern matching using intracardiac electrograms was evaluated on Successful identification of PAC origin and ablation. A modified CARTO pattern matching method using intracardiac electrograms successfully identified the origin of premature atrial complexes in two patients, facilitating targeted catheter ablation.
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