Simultaneous Amplitude Frequency Electrogram Transformation (SAFE-T) Mapping to Identify Ventricular Tachycardia Arrhythmogenic Potentials in Sinus Rhythm

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Title:	Simultaneous Amplitude Frequency Electrogram Transformation (SAFE-T) Mapping to Identify Ventricular Tachycardia Arrhythmogenic Potentials in Sinus Rhythm
Authors:	林澂;Lin, Chin-Yu;Silberbauer, John;Lin, Yenn-Jiang;Lo, Men-Tzung;Lin, Chen;Chang, Hsiang-Chih;Chang, Shih-Lin;Lo, Li-Wei;Hu, Yu-Feng;Chung, Fa-Po;Liao, Jo-Nan;Chen, Yun-Yu;Chiou, Chun-Wang;Chen, Shih-Ann;Della Bella, Paolo
Contributors:	生醫理工學院生醫科學與工程學系
Keywords:	arrhythmogenic potentials;Cardiovascular;catheter ablation;Hilbert-Huang transform;isthmus;ventricular tachycardia
Date:	2016-08-01
Issue Date:	2026-04-23 11:21:15 (UTC+8)
Publisher:	United States: Elsevier Inc
Abstract:	摘要： This study sought to develop a novel automated technique, simultaneous amplitude frequency electrogram transformation (SAFE-T), to identify ventricular tachycardia (VT) isthmuses by analysis of sinus rhythm arrhythmogenic potentials (AP). Substrate ablation is useful for patients with scar-related hemodynamically unstable VT; however, the accuracy of different approaches remains inadequate, varying from targeting late potentials to full scar homogenization. High-density ventricular mapping was performed in 3 groups: 1) 18 normal heart control subjects; 2) 10 ischemic patients; and 3) 8 nonischemic VT patients. In VT patients, isthmus sites were characterized using entrainment responses. Sinus rhythm right ventricle/left ventricle endocardial and epicardial electrograms underwent Hilbert-Huang spectral analysis and were displayed as 3-dimensional SAFE-T maps. AP and their relation to the VT isthmus sites were studied. AP were defined by a cutoff value of 3.08 Hz mV using normal heart control subjects. Receiver-operating characteristics showed that VT isthmus sites were best identified using SAFE-T mapping (p < 0.001) as compared with bipolar and unipolar scar and late potential mapping with an optimal cutoff value of 3.09 Hz mV, allowing identification of 100% of the 34 mapped VT isthmuses, compared with 68% using late potentials. There was no significant difference between sinus rhythm and paced SAFE-T values. Abnormal SAFE-T areas involved about one-quarter of the scar total area. Automated electrogram analysis using 3-dimensional SAFE-T mapping allows rapid and objective identification of AP that reliably detect VT isthmuses. The results suggest that SAFE-T mapping is good alternative strategy to late potential mapping in identifying VT isthmuses and allows reduced ablation as compared to scar homogenization. 其他題名： JACC Clin Electrophysiol 出版者： United States: Elsevier Inc 出版日期： 2016-08-01 出處： JACC. Clinical electrophysiology, 2016-08, Vol.2 (4), p.459-470 資源來源： Alma/SFX Local Collection 版權： 2016 American College of Cardiology Foundation 版權： American College of Cardiology Foundation 版權： Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. 識別號： ISSN: 2405-500X 識別號： ISSN: 2405-5018 識別號： EISSN: 2405-5018 識別號： DOI: 10.1016/j.jacep.2016.01.013 識別號： PMID: 29759866
Appears in Collections:	[Department of Biomedical Sciences and Engineering ] journal & Dissertation

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