Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Mapping & Imaging D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-146 - Dielectric Imaging Of Wall Thickness: Mapping The Fourth Dimension: Preclinical Validation In Animal Model (ID 112)

Disclosure
 D. Shim: Nothing relevant to disclose.

Abstract

Background: Mapping systems do not provide wall thickness data, although this may be important for guiding ablation. A novel technology based on dielectric imaging from intracardiac signals at multiple frequencies has been developed for interrogating wall properties, including thickness.
Objective: To test the accuracy of dielectric imaging-based estimation of wall thickness
Methods: In 7 swine, the right atrium was mapped using KODEX-EPD (Philips) and Blazer™ OI catheter (Boston Scientific). On a line between the superior and inferior vena cava, points were recorded at 5 mm intervals and for temporal repeatability at ≥2 and ≥5 min intervals. The borders of the line were marked with ablation. The tissue was harvested and scanned in 3D. Actual tissue thickness was measured from the 3D by a reviewer blinded to the mapping data and compared to estimated wall thickness.
Results: Actual atrial line thickness ranged from 0.07 mm to 5.38 mm. On average, 20.1 ± 7.7 points/line were recorded, and the number of repetitions was 2.0 ± 0.8. Difference between repetitions was <1mm in 63% of the points. Mean wall thickness was similar between actual and estimated (2.22 ± 0.34 mm vs. 2.03 ± 0.30 mm, p=0.44). Linear regression analysis showed reasonable correlation between actual and estimated measurements (R2 = 0.43). Analysis of binned data demonstrated overestimation in thin tissue (<2mm, p<0.0001), underestimation in thicker tissue (>4 mm, p=0.0001), and accurate estimation in tissue thickness 2-4 mm (p=0.987).
Conclusion: This novel mapping technology provided an overall good estimation of wall thickness between 2-4 mm. Further research is needed to study its utility to estimate a wider range of thickness.
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