Abstract
Mapping of intracardiac electrical signals is a well-established clinical method used to identify the foci of abnormal heart rhythms associated with chronic myocardial infarct (a major cause of death). These foci reside in the ‘border zone’ (BZ) between healthy tissue and dense collagenous scar, and are the targets of ablation therapy. In this work we analyzed detailed features of the electrical signals recorded in a translational animal model of chronic infarct. Specifically, activation maps and bipolar voltages were recorded in vivo from 6 pigs at ~5 weeks following infarct creation, as well as 6 control (normal) pigs. Endocardial and epicardial maps were obtained during normal sinus rhythm and/or pacing conditions via X-ray guided catheter-based mapping using an electro-anatomical CARTO system. The depolarization and repolarization maps were derived through manual annotation of electro-cardiogram waves, where the peak of the QRS wave marked the time of depolarization and the peak of the T wave marked the recovery time. Then, at each recording point, activation-recovery intervals ARIs (clinical surrogates of action potential duration) were found by subtracting activation times from repolarization times. Overall, we observed that ARI values in the BZ have recovered from the acute stage and were close to values in healthy tissue. In general we observed a weak negative correlation between the activation times and ARI values, also not a significant variation (p < 0.5) between mean ARI values in the BZ area and those in the healthy areas.
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References
Stevenson, W.G.: Ventricular scars and VT tachycardia. Trans. Am. Clin. Assoc. 120, 403–412 (2009)
Bolick, D., Hackel, D., Reimer, K., Ideker, R.: Quantitative analysis of myocardial infarct structure in patients with ventricular tachycardia. Circulation 74(6), 1266 (1986)
Ursell, P.C., Gardner, P.I., Albala, A., Fenoglio, J., Wit, A.L.: Structural and electrophysiological changes in the epicardial border zone of canine myocardial infarcts during infarct healing. Circ. Res. 56, 436–451 (1985)
Janse, M.J., Wit, A.L.: Electrophysiological mechanisms of ventricular arrhythmias resulting from myocardial ischemia and infarction. Physiol. Rev. 69(4), 1049–1169 (1989)
Bello, D., Fieno, D.S., Kim, R.J., et al.: Infarct morphology identifies patients with substrate for sustained ventricular tachycardia. J. Am. Coll. Cardiol. 45(7), 1104–1110 (2005)
Pop, M., Ghugre, N.R., Ramanan, V., Morikawa, L., Stanisz, G., Dick, A.J., Wright, G.A.: Quantification of fibrosis in infarcted swine hearts by ex vivo late gadolinium-enhancement and diffusion-weighted MRI methods. Phys. Med. Biol. 58(15), 5009 (2013)
Yan, A., Shayne, A., Brown, K., Gupta, S., Chan, C., Luu, T., Di Carli, M., Reynolds, H., Stevenson, W., Kwong, R.: Characterization of the peri-infarct zone by contrast-enhanced cardiac magnetic resonance imaging is a powerful predictor of post-myocardial infarction mortality. Circulation 114, 32 (2006)
Wijnmaalen, A., van der Geest, R., van Siebelink, C.F.B.H., Wijnmaalen, H., Kroft, L., Bax, J., Reiber, J., Schalij, M., Zeppenfeld, K.: Head-to-head comparison of contrast-enhanced magnetic resonance imaging and electroanatomical voltage mapping to assess post-infarct scar characteristics in patients with ventricular tachycardias: real-time image integration and reversed registration. Eur. Heart J. 32, 104 (2011)
Pop, M., Sermesant, M., Liu, G., Relan, J., Mansi, T., Soong, A., Peyrat, J.-M., Truong, M.V., Fefer, P., McVeigh, E.R., Delingette, H., Dick, A.J., Ayache, N., Wright, G.A.: Construction of 3D MR image-based computer models of pathologic hearts, augmented with histology and optical imaging to characterize the action potential propagation. Med. Image Anal. 16(2), 505–523 (2012)
Verma, A., Kilicaslan, F., Schweikert, R., Tomassoni, G., Rossillo, A., Marrouche, N., Ozduran, V., Wazni, O., Elayi, S., Saenz, L., et al.: Short-and long-term success of substrate-based mapping and ablation of ventricular tachycardia in arrhythmogenic right ventricular dysplasia. Circulation 111(24), 3209 (2005)
Desjardins, B., Crawford, T., Good, E., Oral, H., Chugh, A., Pelosi, F., Morady, F., Bogun, F.: Infarct architecture and characteristics on delayed enhanced MR imaging and electroanatomic mapping in patients with postinfarction ventricular arrhythmia. Heart Rhythm 6(5), 644–651 (2009)
Haws, C.W., Lux, R.L.: Correlation between in vivo transmembrane APD and ARI from EGM. Circulation 81(1), 281–288 (1989)
Pop, M., Ramanan, V., Yang, F., Zhang, L., Newbigging, S., Ghugre, N., Wright, G.A.: High resolution 3D T1* mapping and quantitative image analysis of the gray zone in chronic fibrosis. IEEE Trans. Biomed. Eng. 61(12), 2930–2938 (2014)
Zhang, Y., Wang, H., Kovacs, A., Kanter, E.M., Yamada, K.A.: Reduced expression of Cx43 attenuates ventricular remodelling after myocardial infarction via impaired TBF-B signaling. Am. J. Physiol. Heart Circ. Physiol. 298(2), H477–H487 (2010)
Jansen, J., van Veen, T.A.B., de Jong, S., van der Nagel, R., van Rijen, H.V.M., et al.: Reduced Cx43 expression triggers increased fibrosis due to enhanced fibroblast activity. Circ. Arrhythmia Electrophsiol. 5, 380–390 (2012)
Codreanu, A., Odille, F., Aliot, E., et al.: Electro-anatomic characterization of post-infarct scars comparison with 3D myocardial scar reconstruction based on MR imaging. J. Am. Coll. Cardiol. 52, 839–842 (2008)
Gepstein, L., Hayam, G., Ben-HAim, S.A.: Activation-repolarization coupling in the normal swine endocardium. Circulation 96, 4036–4043 (1997)
Wrobleski, D., Houghtaling, C., Josephson, M.E., Ruskin, J., Reddy, V.: Use of electrogram characteristics during sinus rhythm to delineate the endocardial scar in a porcine model of healed myocardial infarction. J. Cardiovasc. Electrophysiol. 14, 524–529 (2003)
Callans, J.D., Ren, J.-F., Michele, J., Marchlinski, F., Dillon, S.: Electroanatomic left ventricular mapping in the porcine model of healed anterior myocardial infarction. Correlation with intracardiac echocardiography and pathological analysis. Circulation 100, 1744–1750 (1999)
Acknowledgement
This work was financially supported in part by a grant from CIHR (MOP # 93531) and a summer student award D&H (Sunnybrook).
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Denisko, D. et al. (2017). Analysis of Activation-Recovery Intervals from Intra-cardiac Electrograms in a Pre-clinical Chronic Model of Myocardial Infarction. In: Pop, M., Wright, G. (eds) Functional Imaging and Modelling of the Heart. FIMH 2017. Lecture Notes in Computer Science(), vol 10263. Springer, Cham. https://doi.org/10.1007/978-3-319-59448-4_27
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DOI: https://doi.org/10.1007/978-3-319-59448-4_27
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