Key result
Direct epicardial bipolar mapping predicts myocardial recovery after CABG with an AUC of ~0.92.
Why the study?
Direct epicardial bipolar mapping may predict recovery of left ventricular dysfunction in ischaemic myocardium, but its predictive value was not established.
Cohort (n=34)
Answers are grounded in this paper and cite their sources.
May support intraoperative viability mapping in CABG; leaves open prospective validation before clinical adoption.
AIMS: This study investigated the hypothesis that direct epicardial bipolar mapping is able to predict the recovery of left ventricular (LV) dysfunction in ischaemic myocardium. METHODS AND RESULTS: In 34 patients with CAD, a maximum of 102 bipolar epicardial electrograms per patient (n=3468 electrograms) were simultaneously recorded with a ventricular jacket array intraoperatively immediately prior to revascularization. Only LV electrograms with good myocardial contact (n=1813, 52+/-14 per patient, mean+/-SD) were analyzed. In accordance to the position of each electrode, segmental myocardial function was assessed by transthoracic echocardiography before and 7+/-2 months (mean+/-SD; range 3-10 months) after CABG using a wall motion score. Preoperatively dysfunctional segments (n=700) were classified as viable (improvement in wall motion score of at least 20% following CABG, n=424) or non-viable (no improvement, n=276). Bipolar voltage was significantly lower in non-viable when compared to viable myocardium (P<0.001, ANOVA) At a cut-off value of 5.9mV, ROC-curve analysis for bipolar voltage (to discriminate between viable and non-viable myocardium) revealed a sensitivity of 83% at a specificity of 83% (area under the ROC-curve of 0.92+/-0.01, mean+/-SE). CONCLUSIONS: Direct epicardial mapping is able to predict the recovery of chronically ischaemic dysfunctional myocardium and thereby proves the presence of myocardial viability.
No takes yet. Share an insight, caveat, or question.
Christian Vahlhaus (2004) conducted a cohort in Coronary artery disease with left ventricular dysfunction (n=34). Direct epicardial bipolar mapping vs. Non-viable myocardium was evaluated on Recovery of left ventricular dysfunction (improvement in wall motion score of at least 20% following CABG) (AUC 0.92, p=<0.001). Direct epicardial bipolar mapping using a voltage cut-off of 5.9 mV predicted the recovery of chronically ischaemic dysfunctional myocardium with 83% sensitivity and 83% specificity (AUC 0.92).
Synapse has enriched 10 related papers. Consider them for comparative context: