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Computerized methods of pace-mapping for topical diagnosis of ventricular arrhythmias
L A Bockeria1, G V Mirsky, L K Makarova
1Bakulev Institute for Cardiovascular Surgery AMS USSR, Department of Arrhythmias Research, Moscow.
Insights
Computerized pace-mapping effectively diagnoses ventricular arrhythmias (VAs) when tachycardia induction fails. This method precisely localizes VA origins for improved surgical outcomes.
Area of Science:
- Cardiology
- Medical Engineering
- Electrophysiology
Background:
- Surgical treatment of ventricular arrhythmias (VAs) is crucial for preventing sudden cardiac death.
- Accurate topical diagnosis of arrhythmia origin is vital for effective VA surgery.
- Epicardial mapping is common, but challenging when tachycardia is not inducible.
Purpose of the Study:
- To develop computerized methods for precise topical electrocardiogram (ECG) diagnosis of VAs.
- To create a computer-assisted comparative analysis of ECG morphology for spontaneous and stimulated ECG.
- To identify ventricular regions with ECGs closest to spontaneous VAs during ventricular tachycardia.
Main Methods:
- Developed a computerized comparative analysis of ECG morphology.
- Utilized pace-mapping with sequential ventricular electrical stimulation and ECG recording.
- Compared intraoperative stimulated ECGs with preoperative ECGs to find the closest match.
- Studied nine patients (15-57 years old) with VAs.
Main Results:
- The computerized pace-mapping method proved effective for topical diagnostics of VAs.
- Successfully diagnosed VAs that were impossible to induce via electrical programmed stimulation.
- Demonstrated the capability to determine the ventricular point with ECG closest to spontaneous VAs.
Conclusions:
- Computerized pace-mapping is an effective tool for the topical diagnosis of VAs.
- This method addresses the challenge of non-inducible tachycardia during surgery.
- Enhances precision and efficiency in localizing arrhythmia origins for surgical intervention.
Abstract:
Surgical treatment of ventricular arrhythmias (VAs) is an effective method of solving sudden cardiac death. The important problem of surgical treatment of VAs is the topical diagnosis of the origin of arrhythmia. The precise localization of this area is extremely important for effectiveness of operation. The method of epicardial mapping of the heart during the induced paroxysm of VA is widely used for solving this problem. This problem is difficult when it is impossible to induce tachycardia during the operation. The method of pace-mapping was developed for such cases. This method includes sequential electrical stimulation of ventricles with ECG recording and comparison between intraoperative and preoperative ECG. The goal is the identification of the area of ventricles closed to preoperative ECG with VA. Manual processing of these data is difficult and takes time. The results of such processing have a low precision. That is why we propose using computerized methods. The goal of this investigation is to develop computerized methods of topical ECG diagnosis of VA. We propose a method of computer comparative analysis of ECG morphology for spontaneous and stimulated ECG. The goal is the determination with stimulated ECG the point of ventricles with ECG closest to spontaneous ECG during ventricular tachycardia. Nine patients (15-57 years old) with VA were studied. The main result of this investigation is that computerized pace-mapping method is an effective tool for topical diagnostics of different forms of VAs, which is impossible to induce by electrical programmed stimulation.