A Novel Myocardial Impedance Mapping System for Ablation of Post-infarction Ventricular Arrhytmias in Humans
Study Details
Study Description
Brief Summary
Precise identification of the infarct scar is essential for successful catheter ablation of ventricular arrhythmias in patients with chronic myocardial infarction. Voltage mapping of endocardial electrograms is currently used to delineate the necrotic scar but this is influenced by the direction of the activation wave front and is not sensitive enough to differentiate distinct degrees of transmural injury in the scar. Mapping of local myocardial electrical impedance may overcome these limitations.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
Clinical series: Patients with chronic infarction undergoing catheter ablation of ventricular arrhythmias will be submitted to mapping of both voltage and tissue impedance. Likewise, the accuracy of the two maps identifying the extent and transmurality of the infarction will be assesssed by gadolinium imaging. The impedance system is already constructed and certified for clinical research use.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| CASE GROUP patients with chronic infarction undergoing catheter ablation of ventricular arrhythmias |
Device: CardioZ multifrequency impedance recording system
Patients will be submitted to mapping of both voltage and tissue impedance. The accuracy of the two maps identifying the extent and transmurality of the infarction will be assesssed by gadolinium imaging.
Other Names:
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Outcome Measures
Primary Outcome Measures
- Comparative detection of infarct scar by voltage mapping [3 hours]
Voltage will be measured at different sites of the infarct scar and healthy tissue.
- Comparative detection of infarct scar by impedance mapping [3 hours]
myocardial local impedance will be measured at different sites of the infarct scar and healthy tissue.
- Comparative detection of infarct scar by gadolinium enhanced MR imaging [30 minutes]
Intensity of gadolinium will be measured at different sites of the infarct scar and healthy tissue.
Eligibility Criteria
Criteria
Inclusion Criteria:
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More than 18 yearts
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Chronic myocardial infarction
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Undergoing ventricular ablation of ventricular arrhythmias
Exclusion Criteria:
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patients with device not suitable for cardiac magnetic ressonance (CMR)
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pregnacy
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Hospital de la Santa Creu i Sant Pau | Barcelona | Spain | 08026 |
Sponsors and Collaborators
- Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau
- Universitat Politècnica de Catalunya
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Amorós-Figueras G, Jorge E, Alonso-Martin C, Traver D, Ballesta M, Bragós R, Rosell-Ferrer J, Cinca J. Endocardial infarct scar recognition by myocardial electrical impedance is not influenced by changes in cardiac activation sequence. Heart Rhythm. 2018 Apr;15(4):589-596. doi: 10.1016/j.hrthm.2017.11.031. Epub 2017 Dec 27.
- Amorós-Figueras G, Jorge E, García-Sánchez T, Bragós R, Rosell-Ferrer J, Cinca J. Recognition of Fibrotic Infarct Density by the Pattern of Local Systolic-Diastolic Myocardial Electrical Impedance. Front Physiol. 2016 Aug 31;7:389. doi: 10.3389/fphys.2016.00389. eCollection 2016.
- Jorge E, Amorós-Figueras G, García-Sánchez T, Bragós R, Rosell-Ferrer J, Cinca J. Early detection of acute transmural myocardial ischemia by the phasic systolic-diastolic changes of local tissue electrical impedance. Am J Physiol Heart Circ Physiol. 2016 Feb 1;310(3):H436-43. doi: 10.1152/ajpheart.00754.2015. Epub 2015 Nov 25.
- IIBSP-IMS-2015-90