Sequential Electro-Anatomical Mapping Methodology and Preliminary Results for Reentry Vulnerability Index Estimation

Michele Orini*, Ben Hanson, Peter Taggart, Fernando Campos, Aldo Rinaldi, Jaswinder Gill, Martin Bishop, Pier D. Lambiase

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingConference paperpeer-review


Ventricular tachycardia (VT) recurrence after catheter ablation remains frequent and improved ablation strategies are needed. The re-entry vulnerability index (RVI) is an activation-repolarization marker to localize critical sites for VT initiation. Its use is limited since current electro-anatomical mapping systems (EAMS) cannot provide global measurement of activation and repolarization times within a single beat. We carried out a simulation study to assess a simple method to measure RVI using data collected by sequential EAMS and we investigated the effect of background noise, RT variability (σ RT) and ectopics on RVI estimation. The mean correlation coefficient between single ECG beats and a representative template is used as inclusion/exclusion criterion. Localization of the vulnerable region associated with 5% bottom RVI was accurate (sensitivity 80±8%, specificity> 99± 1%) for moderate to large repolarization variability (5 ≤ σRT ≤ 20 ms) and moderate level of noise (S N R ≥ 10 dB) but it deteriorated for σRT ≥ 25 ms and S N R < 5 dB. Sensitivity remained high even when RVI estimates were only moderately accurate (cc > 0.67 ± 0.05, MAE < 25 ± 1 ms). The number of ectopic beats did not affect the results. In the in-vivo case analyzed, the sites of low RVI and VT exit was close (5.1 mm).

Original languageEnglish
Title of host publicationComputing in Cardiology Conference, CinC 2018
PublisherIEEE Computer Society
ISBN (Electronic)9781728109589
Publication statusPublished - 1 Sept 2018
Event45th Computing in Cardiology Conference, CinC 2018 - Maastricht, Netherlands
Duration: 23 Sept 201826 Sept 2018


Conference45th Computing in Cardiology Conference, CinC 2018


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