Validation of an automated premature ventricular contraction mapping algorithm

TL;DR

This paper introduces an automated algorithm for mapping premature ventricular contractions, improving accuracy and efficiency in cardiac ablation procedures.

Contribution

The novel contribution is an automated LAT-hybrid algorithm that corrects spatial displacement in PVC mapping with accuracy comparable to manual methods.

Findings

The automated algorithm achieved a mean hybrid distance of 4.03 ± 2.33 mm.

The algorithm significantly reduced RF time and PVC offset compared to conventional methods.

The LAT-hybrid module successfully directed ablation to the correct site with single burn elimination in LVOT cases.

Abstract

Catheter mapping and ablation of premature ventricular contractions (PVCs) requires accurate annotation of earliest local activation time (LAT), but displacement in catheter position between sinus rhythm (SR) and the PVC complicates three-dimensional mapping localization. An automated algorithm to annotate LAT sites at the corresponding sinus rhythm sites would provide an alternative to manual annotation and improve procedural efficiency.

A retrospective single center study assessed 64 patients undergoing catheter ablation of PVCs. We divided the study patients into two groups: the patients underwent RF ablation using the CARTO 3 version 7 with LAT-hybrid™ module (hybrid group) and the other patients using the CARTO 3 version 6 without LAT-hybrid™ module (conventional group).

The primary results of this study demonstrate that the mean hybrid distance is 4.03 ± 2.33 mm, and this automated algorithm can correct for the positional shift with accuracy comparable to manual correction. Moreover, this algorithm showed significantly shorter RF time and the shorter PVC offset compared to the conventional method.

PVC mapping with the LAT-hybrid™ module demonstrated that an automated algorithm can map in more detail with no compromise in accuracy. The LAT-hybrid™ module showed significantly shorter RF time and PVC offset from the earliest LAT in LVOT cases.

Spatial displacement of earliest site of activation for premature ventricular contractions (PVCs) relative to sinus rhythm beats in high-risk para-His bundle region. Automated spatial correction (LAT-Hybrid) provides a more focal area of interest 1.4mm posterior to the His region adjacent to the tricuspid annulus. The LAT-Hybrid automated algorithm directed ablation to the successful site with single burn elimination.

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