Left ventricular electromechanical mapping for detection of myocardial viability in patients with impaired left ventricular function

H. E. Betker*, J. F. Lassen*, F. Hermansen, P. Sogaard, Y. Kim, A. K. Pedersen, L. Thuesen

*Kontaktforfatter

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

Abstract

Purpose. NOGA is a 3-dimensional left ventricular (LV) mapping system that uses low-intensity magnetic field energy to determine the localisation of sensor-tipped electrode catheters within the heart. We evaluated the ability of the system to distinguish between irreversibly and reversibly dysfunctional myocardium in patients with impaired LV-ftmction due to ischaemic heart disease. Methods. Unipolar voltage potentials and local endocardia! shortening were measured in 13 patients (mean±SD age S9±12 years) with ischaemic cardiomyopathy (EF 32±10%). Dysfunctional regions, identified by 2-D echocardiography, were characterised as irreversible when positron emission tomography (PET) revealed matched reduction of perfusion (13NH4) and metabolism (18FDG) and reversible when perfusion was reduced and metabolism preserved. For comparison with echocardiography and PET LV-mapping data were entered in a 9-segmental polar map. The long axis of the heart was divided into 3 segments: apex, midventricle, and base, consisting of 20%, 40%, and 40% of the long axis, respectively. The apex constituted one segment, while the midventricular and base segments were further divided into 4 regions: anterior, septal, inferoposterior, and lateral. ffemte Out of 117 segments. 115 were assessable. Unipolar voltage (mV) Local Shortening (%) Normal(n=36) 11.5±3.7 7.7+3.3 Reversible (n=30) 7.3±3.14.2±2.5 Irreversible (n=49) 4.9±2.2 t2.9J2.9P<0!01 vs. normal,P<0.01 vs. reversible. Mean±SD. Conclusion. LV electromechanical mapping detects electrical as well as mechanical impairment in irreversibly dysfunctional myocardium and impaired mechanical but preserved electrical activity in reversibly dysfunctional myocardium. LV mapping may enable detection of on-line mvocardial viability in the catheterisation laboratory.

OriginalsprogEngelsk
TidsskriftScandinavian Cardiovascular Journal, Supplement
Vol/bind33
Udgave nummer51
Sider (fra-til)34
Antal sider1
ISSN1401-7458
StatusUdgivet - 1999
Udgivet eksterntJa

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