Sensitivity and specificity of substrate mapping: An in silico framework for the evaluation of electroanatomical substrate mapping strategies

Update item information
Publication Type pre-print
School or College College of Engineering
Department Bioengineering
Creator Macleod, Robert S.
Other Author Blauer, Joshua J. E.; Swenson, Darrell; Higuchi, Koji; Plank, Gernot; Ranjan, Ravi; Marrouche, Nassir
Title Sensitivity and specificity of substrate mapping: An in silico framework for the evaluation of electroanatomical substrate mapping strategies
Date 2014-01-01
Description Background - Voltage mapping is an important tool for characterizing proarrhythmic electrophysiological substrate, yet it is subject to geometric factors that influence bipolar amplitudes and thus compromise performance. The aim of this study was to characterize the impact of catheter orientation on the ability of bipolar amplitudes to accurately discriminate between healthy and diseased tissues. Methods and Results - We constructed a three-dimensional, in-silico, bidomain model of cardiac tissue containing transmural lesions of varying diameter. A planar excitation wave was stimulated and electrograms were sampled with a realistic catheter model at multiple positions and orientations. We carried out validation studies in animal experiments of acute ablation lesions mapped with a clinical mapping system. Bipolar electrograms sampled at higher inclination angles of the catheter with respect to the tissue demonstrated improvements in both sensitivity and specificity of lesion detection. Removing low voltage electrograms with concurrent activation of both electrodes, suggesting false attenuation of the bipolar electrogram due to alignment with the excitation wavefront, had little effect on the accuracy of voltage mapping. Conclusions - Our results demonstrate possible mechanisms for the impact of catheter orientation on voltage mapping accuracy. Moreover, results from our simulations suggest that mapping accuracy may be improved by selectively controlling the inclination of the catheter to record at higher angles with respect to the tissue.
Type Text
Publisher Wiley-Blackwell
Language eng
Bibliographic Citation Blauer, J. J. E., Swenson, D., Higuchi, K., Plank, G., Ranjan, R., Marrouche, N., & Macleod, R. S. (2014). Sensitivity and specificity of substrate mapping: An in silico framework for the evaluation of electroanatomical substrate mapping strategies. Journal of Cardiovascular Electrophysiology.
Rights Management (c) Wiley-Blackwell The definitive version is available at www3.interscience.wiley.com ; This is the pre-peer reviewed version of the following article: Blauer, J. J. E., Swenson, D., Higuchi, K., Plank, G., Ranjan, R., Marrouche, N., & Macleod, R. S. (2014). Sensitivity and specificity of substrate mapping: An in silico framework for the evaluation of electroanatomical substrate mapping strategies. Journal of Cardiovascular Electrophysiology, which has been published in final form at DOI: 10.1111/jce.12444.
Format Medium application/pdf
Format Extent 2,288,552 bytes
Identifier uspace,18720
ARK ark:/87278/s62v5r7w
Setname ir_uspace
Date Created 2014-08-06
Date Modified 2021-05-06
ID 712610
Reference URL https://collections.lib.utah.edu/ark:/87278/s62v5r7w
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