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Automatic annotation of local activation time was improved in idiopathic right ventricular outflow tract ventricular arrhythmia by novel electrogram “Lumipoint” algorithm

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

Precise automatic annotation of local activation time (LAT) is crucial for rapid high-density activation mapping in arrhythmia. However, it is still challenging in voltage-transitional areas where local low-amplitude near-field potentials are often obscured by large far-field potentials. The aim of this study was to explore the viability and validity of automatic identification of the earliest activation (EA) in idiopathic right ventricular outflow tract ventricular arrhythmias (RVOT VAs) using a novel Lumipoint algorithm.

Methods and results

Twenty-seven patients with RVOT VAs were mapped with Rhythmia mapping system. Lumipoint algorithms were applied to reannotate the initial activation regions retrospectively. The results showed that LATs were reannotated in 35.0 ± 11.4% points in the initial activation area from bipolar activation breakout time (BBO) to the its 40 ms earlier timepoint. The automatically determined bipolar earliest activation time after Lumipoint reannotation (BEAT-lu: − 111.26 ± 12.13 ms) was significantly earlier than that before (BEAT: − 108.67 ± 12.25 ms, P = 0.000). Compared with manually corrected earliest activation time (EAT), the difference between EAT and BEAT-lu (DEAT-BEAT-lu: 6 (2–7) ms) was significantly smaller than that between EAT and BEAT (DEAT-BEAT/DEAT-UEA: 7 (4–11) ms, P = 0.000). The incidence of EAT and BEAT-lu being the same site was significantly higher than that between EAT and BEAT (48.15% vs 18.52%, P = 0.021).

Conclusions

RVOT VAs often originate from voltage-transitional zone, and automatic annotation of LAT usually located at later high-amplitude far-field potential. Lumipoint algorithms could improve the accuracy of LAT automatic annotation, and it was plausible to ablate RVOT VAs just according to the automatically annotated BEAS-lu.

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Author notes

  1. Menghui Liu, Daya Yang and Chen Su contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Menghui Liu, Daya Yang, Chen Su, Jie Li, Jingzhou Jiang, Yuedong Ma, Chong Feng, Jun Liu, Anli Tang, Yugang Dong, Jiangui He & Lichun Wang

  2. Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, 510080, Guangdong, People’s Republic of China

    Menghui Liu, Daya Yang, Chen Su, Jie Li, Jingzhou Jiang, Yuedong Ma, Chong Feng, Jun Liu, Anli Tang, Yugang Dong, Jiangui He & Lichun Wang

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  1. Menghui Liu
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  2. Daya Yang
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  3. Chen Su
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Correspondence to Jiangui He or Lichun Wang.

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Liu, M., Yang, D., Su, C. et al. Automatic annotation of local activation time was improved in idiopathic right ventricular outflow tract ventricular arrhythmia by novel electrogram “Lumipoint” algorithm. J Interv Card Electrophysiol 61, 79–85 (2021). https://doi.org/10.1007/s10840-020-00773-3

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  • DOI: https://doi.org/10.1007/s10840-020-00773-3

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