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Journal articles on the topic 'CARTO 3'

Author: Grafiati

Published: 4 June 2021

Last updated: 1 February 2022

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1

Yamaguchi, Tetsuo, Shingo Maeda, Hiroyuki Okada, Susumu Tao, Nobuyuki Kagiyama, Takaki Naito, Nobuhiro Hara, et al. "CARTO 3-Guided or CARTO XP-Guided Pulmonary Vein Isolation Compared with Fluoroscopy-Guided Pulmonary Vein Isolation." Journal of Arrhythmia 27, Supplement (2011): PJ1_018. http://dx.doi.org/10.4020/jhrs.27.pj1_018.

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2

Kimura, Masaomi, and Ken Okumura. "Usefulness of CARTO 3 System in Ablating Paroxysmal Atrial Fibrillation." Journal of Arrhythmia 27, Supplement (2011): MS3_1. http://dx.doi.org/10.4020/jhrs.27.ms3_1.

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3

Black, Jeremy. "Historical Atlas of the United States, with Original MapsHISTORICAL ATLAS OF THE UNITED STATES, WITH ORIGINAL MAPS / HayesDerek. Vancouver: Douglas & McIntyre, 2006. 280 p.: ill. (chiefly col.), maps (chiefly col.); 35 cm. Includes bibliographical references (pp. 270–71) and index. ISBN-10 1-55365-205-3, ISBN-13 978-1-55365-205-2, CAD$55.00. Available from: ." Cartographica: The International Journal for Geographic Information and Geovisualization 42, no. 2 (June 2007): 189–90. http://dx.doi.org/10.3138/carto.42.2.189.

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4

Pang, Lingpin, Song-wen Chen, Gen-qing Zhou, Yong Wei, Can Chen, Shi-an Huang, and Shao-wen Liu. "A Practical Method for Ablation Catheter Reintroduction into the Left Atrium via Prior Transseptal Puncture, without Radiation." Heart Surgery Forum 22, no. 6 (December 3, 2019): E470—E475. http://dx.doi.org/10.1532/hsf.2621.

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Background: We evaluated the feasibility and safety of reintroducing an ablation catheter (ABL) into the left atrium (LA) through a previously punctured interatrial septum under guidance of the show-catheter image-track function of the CARTO 3 3-dimensional (3D) electroanatomic mapping system. Methods: One hundred consecutive paroxysmal or persistent drug-refractory atrial fibrillation (AF) patients (men: 55; mean age, 64.7 ± 12.1 years) who had undergone 2 fluoroscopy-guided transseptal punctures and anatomical LA reconstruction under CARTO 3-guidance, and required ABL reinsertion into the LA during mapping or ablation, were included. They were randomized 1:1 to the show-catheter (reintroduction under the CARTO 3 show-catheter image-track function) or fluoroscopy group (reintroduction under conventional fluoroscopy). Results: Although the reconstructed 3D anatomy map was displaced in 21/100 patients (21.0%), the ABL was successfully reintroduced in all patients. In the show-catheter and fluoroscopy groups, model displacement incidence (18% versus 24%), tachyarrhythmias (46.0% versus 52.0%), complications (2% versus 4%), and number of ABLs reintroduced into the LA (3.3 ± 0.8 versus 3.1 ± 0.9) were similar (all P > .05). The show-catheter group displayed shorter ABL reintroduction time (9.5 ± 5.5 s versus 156.4 ± 35.5 s, P < .01), ABL reintroduction X-ray exposure time (0 s versus 39.3 ± 13.8 s, P < .01), and total X-ray exposure time (4.1 ± 1.4 min versus 4.7 ± 0.8, P < .05). Conclusion: During AF ablation, the catheter can be safely reintroduced into the LA, without additional fluoroscopy, under guidance of the CARTO 3 show-catheter image track function.

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5

Huang, Henry D., Parikshit S. Sharma, Hemal M. Nayak, Nicholas Serafini, and Richard G. Trohman. "How to perform electroanatomic mapping-guided cardiac resynchronization therapy using Carto 3 and ESI NavX three-dimensional mapping systems." EP Europace 21, no. 11 (August 21, 2019): 1742–49. http://dx.doi.org/10.1093/europace/euz229.

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Abstract Aims To examine the feasibility and safety of a novel protocol for low fluoroscopy, electroanatomic mapping (EAM)-guided Cardiac resynchronization therapy with a defibrillator (CRT-D) implantation and using both EnSite NavX (St. Jude Medical, St. Paul, MN, USA) and Carto 3 (Biosense Webster, Irvine, CA, USA) mapping systems. Methods and results Twenty consecutive patients underwent CRT implantation using either a conventional fluoroscopic approach (CFA) or EAM-guided lead placement with Carto 3 and EnSite NavX mapping systems. We compared fluoroscopy and procedural times, radiopaque contrast dose, change in QRS duration pre- and post-procedure, and complications in all patients. Fluoroscopy time was 86% lower in the EAM group compared to the conventional group [mean 37.2 min (CFA) vs. 5.5 min (EAM), P = 0.00003]. There was no significant difference in total procedural time [mean 183 min (CFA) vs. 161 min (EAM), P = 0.33] but radiopaque contrast usage was lower in the EAM group [mean 16 mL (CFA) vs. 4 mL (EAM), P = 0.006]. Likewise, there was no significant change in QRS duration with BiV pacing between the groups [mean −13 (CFA) vs. −25 ms (EAM), P = 0.09]. Conclusion Electroanatomic mapping-guided lead placement using either Carto or ESI NavX mapping systems is a feasible alternative to conventional fluoroscopic methods for CRT-D implantation utilizing the protocol described in this study.

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6

Ishida, Yuji, Shingo Sasaki, Masaomi Kimura, Shingen Owada, Daisuke Horiuchi, Sasaki Kenichi, Taihei Itoh, and Ken Okumura. "Comparison of the Efficacy of CARTO 3 System with That of CARTO-XP in the Procedure of Circumferential Pulmonary Vein Isolation." Journal of Arrhythmia 27, Supplement (2011): PJ3_019. http://dx.doi.org/10.4020/jhrs.27.pj3_019.

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7

Kagiyama, Nobuyuki, Shingo Maeda, Hiroyuki Okada, Susumu Tao, Takaki Naito, Tetsuo Yamaguchi, Nobuhiro Hara, et al. "Utility of Rotate 3D Angiography with CARTO 3 Guided Pulmonary Vein Isolation." Journal of Arrhythmia 27, Supplement (2011): PJ1_041. http://dx.doi.org/10.4020/jhrs.27.pj1_041.

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8

Rosu, Radu, Lucian Muresan, Gabriel Cismaru, Mihai Puiu, Marius Andronache, Gabriel Gusetu, Csongor Grosz, et al. "Catheter ablation of idiopathic ventricular fibrillation using the CARTO 3 mapping system." Egyptian Heart Journal 67, no. 4 (December 2015): 349–52. http://dx.doi.org/10.1016/j.ehj.2015.03.001.

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9

Yadav, R., N. Naik, R. Juneja, G. Sharma, S. Ramakrishnan, S. Anandraja, and KK Talwar. "Radio Frequency Ablation of Complex Arrhythmias Using Carto System." Nepalese Heart Journal 3, no. 3 (November 30, 2004): 63. http://dx.doi.org/10.3126/njh.v3i3.26097.

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We present our initial experience with the use of CARTO system in mapping and ablation of complex arrhythmias. 33 patients (mean age 37±11.3 years, 23 males) were Studied. Clinical arrhythmias were atrial flutter (AF) in 5, intra-atrial reentrant tachycardia (IART) in 7, ectopic atrial tachycardia (EAT) in 3, inappropriate sinus tachycardia in I, Arrhythmogenic right ventricular cardiomyopathy (ARVC) in 5, fascicular VT in 1, left ventricular outflow (LVOT) VT in 3, ischemic VT in 2, right ventricular outflow (RVOT) VT, in 1 and left, ventricular (LV) VT in 5. There were 2 coronary artery disease, 5 ARVC, 1 each of dilated & restrictive cardiomyopathy, atrial septal defect and mitral stenosis. Nine patients had congenital heart disease, while 3 patients of left ventricular tachycardia had Left ventricular hypertrophy (LVH). Ablation was successful in 4 patients with AF, 5 with IART, 2 with EAT (1 non inducible), all LVOT VT, 2 with LVVT, 4 with ARVC and one each in the fascicular and RVOT VT. One patient with ischemic VT, 2 with ARVC and 1 with LVOT had recurrence, Two patients developed an allergic response to the reference patch.

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10

Baszko, Artur, Mateusz Kłaczyński, Piotr Kałmucki, Wojciech Telec, and Andrzej Szyszka. "The bipolar ablation of refractory typical atrial flutter with CARTO 3 Confidense system." EP Europace 20, no. 6 (August 4, 2017): 942. http://dx.doi.org/10.1093/europace/eux168.

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11

Radchenko, Lyudmila K., and Olga N. Nikolaeva. "COGNITIVE ASPECT IN CARTOGRAPHY: RATIONAL AND SENSUAL COGNITION." Vestnik SSUGT (Siberian State University of Geosystems and Technologies) 26, no. 3 (2021): 108–15. http://dx.doi.org/10.33764/2411-1759-2021-26-3-108-115.

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The article discusses the basic terms and concepts of human cognitive ability in terms of carto-graphic research method and use of cartographic products to gain new knowledge about the environ-ment. The definition of the main forms of cognition (rational and sensual) is given. The main forms of rational cognition are listed. Differences between rational and sensual cognition are formulated. The definitions of the basic operations of rational cognition are given. The role of each of the operations in the process of making and using maps is characterized. The importance of sensual cognition in cartog-raphy is noted. The influence of the peculiarities of sensual cognition on perception of the world and cartographic products are given. Conclusions about the increasing role of sensual cognition in the per-ception of maps, due to the development of geoinformation mapping and computer design are made.

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12

Burrell, Lance D., Peter J. Weiss, and Brian K. Whisenant. "Biopsy of a complicated right atrial mass using CARTO 3-dimensional electro-anatomic mapping." Catheterization and Cardiovascular Interventions 84, no. 7 (July 19, 2014): E61—E64. http://dx.doi.org/10.1002/ccd.25600.

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13

Demhardt, Imre Josef. "A provisional guide to German military topographic map series of Ottoman Asia in the First World War." Proceedings of the ICA 3 (August 6, 2021): 1–17. http://dx.doi.org/10.5194/ica-proc-3-6-2021.

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Abstract. In acknowledgment that no war can be fought without maps, German military cartography between 1915 and 1918 gradually extended its cartographic involvement in the Ottoman theaters of Sinai, Mesopotamia and Palestine. By the end of the Great War, six topographical map series had been specially produced: Operationskarte in 1:800,000, Karte des türkisch-ägyptischen Grenzgebietes in 1:250,000, Karte von Mesopotamien (und Syrien) in 1:400,000, Karte von Nordbabylonien in 1:200,000, and Karte von Palästina in three scales 1:100,000, 1:50,000, and 1:25,000. The paper makes the first attempt on a carto-bibliographical appraisal of these map series.

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14

Pass, Robert H., Gregory G. Gates, Laura A. Gellis, Lynn Nappo, and Scott R. Ceresnak. "Reducing patient radiation exposure during paediatric SVT ablations: use of CARTO® 3 in concert with “ALARA” principles profoundly lowers total dose." Cardiology in the Young 25, no. 5 (August 22, 2014): 963–68. http://dx.doi.org/10.1017/s1047951114001474.

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AbstractBackground: “ALARA – As Low As Reasonably Achievable” protocols reduce patient radiation dose. Addition of electroanatomical mapping may further reduce dose. Methods: From 6/11 to 4/12, a novel ALARA protocol was utilised for all patients undergoing supraventricular tachycardia ablation, including low frame rates (2–3 frames/second), low fluoro dose/frame (6–18 nGy/frame), and other techniques to reduce fluoroscopy (ALARA). From 6/12 to 3/13, use of CARTO® 3 (C3) with “fast anatomical mapping” (ALARA+C3) was added to the ALARA protocol. Intravascular echo was not utilised. Demographics, procedural, and radiation data were analysed and compared between the two protocols. Results: A total of 75 patients were included: 42 ALARA patients, and 33 ALARA+C3 patients. Patient demographics were similar between the two groups. The acute success rate in ALARA was 95%, and 100% in ALARA+C3; no catheterisation-related complications were observed. Procedural time was 125.7 minutes in the ALARA group versus 131.4 in ALARA+C3 (p=0.36). Radiation doses were significantly lower in the ALARA+C3 group with a mean air Kerma in ALARA+C3 of 13.1±28.3 mGy (SD) compared with 93.8±112 mGy in ALARA (p<0.001). Mean dose area product was 92.2±179 uGym2 in ALARA+C3 compared with 584±687 uGym2 in ALARA (p<0.001). Of the 33 subjects (42%) in the ALARA+C3 group, 14 received ⩽1 mGy exposure. The ALARA+C3 dosages are the lowest reported for a combined electroanatomical–fluoroscopy technique. Conclusions: Addition of CARTO® 3 to ALARA protocols markedly reduced radiation exposure to young people undergoing supraventricular tachycardia ablation while allowing for equivalent procedural efficacy and safety.

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15

Page, Stephen P., and Mehul Dhinoja. "SmartTouch™ – The Emerging Role of Contact Force Technology in Complex Catheter Ablation." Arrhythmia & Electrophysiology Review 1 (2012): 59. http://dx.doi.org/10.15420/aer.2012.1.59.

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Novel technologies have been developed recently to assess contact between the ablation catheter and the underlying tissue in an attempt to improve safe and effective lesion delivery. The most recently developed technology is the SmartTouch™ catheter which is an open irrigated-tip catheter integrated within the CARTO 3 3D mapping system. In this review we consider the role of contact force technology, evaluate the published data and discuss the potential applications of this novel technology.

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16

Cismaru, Gabriel, Radu Rosu, Nihal El Kamar, Lucian Muresan, Mihai Puiu, Marius Andronache, Paul Puie, et al. "Distance between the Left Atrial Appendage and Mitral Annulus Evaluated by CARTO 3 Integrated Computed Tomography Imaging." Medical Principles and Practice 24, no. 6 (July 24, 2015): 555–59. http://dx.doi.org/10.1159/000431371.

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17

Sieber, René, Remo Eichenberger, and Lorenz Hurni. "3D Carto-Graphics – Principles, Methods and Examples for Interactive Atlases." Abstracts of the ICA 1 (July 15, 2019): 1. http://dx.doi.org/10.5194/ica-abs-1-338-2019.

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<p><strong>Abstract.</strong> Atlases are designed to visualize, explore and analyze topographic and thematic information in a geographic environment. As 3D data and real-time display techniques are increasingly available, a trend towards 3D atlases can be observed like the newly released Earth 3D Amazing Atlas (2017) and the Atlas of Switzerland &ndash; online (2016). While creating such interactive 3D atlases, editors are often confronted with the question: How realistic should a cartographic 3D representation look like? Can we introduce some visualization guidelines or even rules to determine the „graphic style“ of cartographic 3D elements? 3D visualizations tend to let users ask for more and more details, leading to photorealistic representations. But photorealism is mostly not suited to pin point the characteristics of a theme; obviously, a creek or a trail would hardly be recognized in a forest area. As Goralski (2009, p.3) states: “3D maps are not meant to be realistic 3D representations of the real world. As in other map types, cartographic rules of abstraction, symbolization and generalization have to be used, to assure efficient transfer of the depicted geographical information, tailored to the purpose, and suitable for the target map user.”</p><p>In our presentation, we will clarify the term of 3D carto-graphics, depict principles, and describe suitable methods and corresponding techniques. In the context of the national Atlas of Switzerland, we will apply and examine these design concepts for 3D representations within the 3D mapping space (Sieber et al. 2013).</p><p>A carto-graphic style for 3D is based on 2D cartographic rules (Imhof 1965) and non-photorealistic computer graphics (Doellner 2012, Bodum 2005). Principles concerning 3D modeling are fundamental for the different representational aspects. In this context, we will discuss principles such as a degree of realism, the level of visual complexity of 3D maps, the graphic quality of map elements, the 3D visualization and symbolization (Near-Far/Distance-Density problem), etc. considering dynamic and real-time applications. As an example of a 3D principle, the <i>visualization</i> should always originate from 3D data; thus a 2D map is a special case of a 3D map (Sieber et al. 2012).</p><p><i>Methods and techniques</i> of 3D modeling affect the whole 3D scene consisting of terrain/topography, and different map objects. We will present some ideas and techniques how to treat 3D topography, and objects like point symbols, charts, lines, areas and solid objects considering real-time interaction. As an example of such methods recommended in the field of 3D topography, DTMs should be based on high-resolution and smoothed TINs applying techniques of low poly height fields (Ferguson 2013). Adaptive DTM smoothing using topographic position index (TPI) and filtering techniques are also taken into consideration (Guisan et al. 1999, Kettunen et al. 2017). For appropriate relief shading, an exemplary approach using smoothing and enhance techniques is suggested (Geisthövel 2017).</p><p>To illustrate the described methods and techniques, we present and discuss characteristic examples from various application fields. Examples may come from cartography, computer graphics, and even from data journalism and info-graphics. In order to demonstrate the feasibility and the usability of this approach, we plan to implement a set of 3D visualizations, which can be interacted with in real-time by means of the Virtual Globe engine of the Atlas of Switzerland &ndash; online.</p>

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18

Romanov, A. B., V. V. Shabanov, D. V. Losik, D. A. Elesin, I. G. Stenin, S. M. Minin, N. A. Nikitin, I. L. Mikheenko, and E. A. Pokushalov. "Visualisation and Radiofrequency Ablation of Sympathetic Innervation Loci in the Left Atrium in Patients with Paroxysmal Atrial Fibrillation." Kardiologiia 59, no. 4 (April 18, 2019): 33–38. http://dx.doi.org/10.18087/cardio.2019.4.10249.

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Introduction: A novel cardiac gamma camera utilizes the radiopharmaceutical Iodine-123-Meta-iodobenzylguanidine (123I-MIBG) to visualize cardiac sympathetic innervation. Physiological accumulation of123I-mIBG provides an anatomical quantitative determination of the structures of the autonomic nervous system (ANS) with discrete uptake areas (DUA) of sympathetic activity located in the left atrium (LA) corresponding to the main ganglionic plexi (GP) clusters that could not previously be visualized.Aim: to visualize the DUA of the heart in patients with paroxysmal atrial fibrillation (AF) and to assess the effect of radiofrequency ablation (RFA) on DUA in LA.Materials and Methods. Computed tomography (CT) of the heart and radionuclide imaging with123I-mIBG were performed in 15 patients with paroxysmal AF. The results of the study were combined with preliminary taken CT images to create a detailed anatomical map of the sympathetic activity of the heart. The processed images were combined with the 3D reconstruction of the LA, obtained with the navigation system (CARTO 3, CARTO RMT). In DUA, high-frequency stimulation (HFS) followed by RF ablation was performed using the current recommended parameters.Results. Forty-eight DUA (median 3 [3; 3]) were identified. Average activity of DUA was 1315 [1171; 1462] cnt / sec / ml. Positive response to HFS in the DUA was obtained in 8 (53.3 %) patients. Prior to ablation, no response was received to HFS in areas of LA outside the DUA. After ablation, there was no response to HFS in the DUA sites. At repeated scans 3 DUA (median 0 [0; 0]; p<0.001 compared with preoperative data) were observed. Activity of DUA significantly decreased to 819 [684; 955] cnt / sec / ml (p<0.001 as compared with preoperative data). Thirteen of 13 of 15 patients (87 %) had no AF / AT / AFL recurrences for 6 month follow up.Conclusion. In patients with AF, the areas of sympathetic activity in LA can be visualized by physiological localized uptake of123I-mIBG. Radiofrequency catheter ablation can target the identified sympathetic innervation structures in AF patients precisely and effectively.

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19

Abdrakhmanov, Ayan, Aliya Smagulova, and Bayan Ainabekova. "Successful Ablation of Ventricular Arrhythmia Without Fluoroscopy Guided by Carto 3 System in Pregnant Woman Without Structural Heart Disease." International Journal of Women's Health and Reproduction Sciences 8, no. 2 (February 28, 2020): 236–38. http://dx.doi.org/10.15296/ijwhr.2020.38.

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Introduction: Arrhythmias can take place in any period of pregnancy. In addition, the incidence of life-threatening ventricular arrhythmias in a pregnant woman without the organic pathology of the heart is rare. Interventional treatment should be carried out in cases of severe arrhythmias and drug resistance. The radiation exposure during ablation carries a potentially harmful effect on the mother and fetus although data on the zero-fluoroscopy ablation of arrhythmias in pregnant women is limited. Case Presentation: A 26-year-old female without structural heart disease at the gestation period of 26-28 weeks was admitted to a hospital due to severe symptoms of ventricular tachycardia (VT) and premature ventricular contractions. In this regard, the conservative therapy of β-blockers was ineffective and accompanied by a decrease in blood pressure to 60/40 mm Hg. Results: An intracardiac electrophysiological study and non-fluoroscopic catheter ablation were carried out considering the drug refractory and severe symptoms of VT. The ablation of the arrhythmia substrate was successfully performed using the Carto 3 System without fluoroscopy. Based on the results, the procedure was not associated with any maternal or fetal complications. Conclusions: In general, the non-fluoroscopic catheter ablation guided by electro-anatomical mapping and navigation systems is safe and applicable in the treatment of pregnant women with severe types of arrhythmias.

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20

WNUKWOJNAR, A. "A37-3 Linear ablation during sinus rhythm for life-threatening ventricular tachycardia in patients with ischemic cardiomyopathy using CARTO system." Europace 4 (December 2003): B57. http://dx.doi.org/10.1016/s1099-5129(03)91719-3.

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21

NAGARAJU, LAKSHMI, DIPIKA MENON, and PETER F. AZIZ. "Use of 3D Electroanatomical Navigation (CARTO-3) to Minimize or Eliminate Fluoroscopy Use in the Ablation of Pediatric Supraventricular Tachyarrhythmias." Pacing and Clinical Electrophysiology 39, no. 6 (March 15, 2016): 574–80. http://dx.doi.org/10.1111/pace.12830.

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22

Sandgaard, N., J. Pontoppidan, A. Osmanagic, and JB Johansen. "P1734Advanced image integration with the carto 3 system in ablation of ventricular extrasystoli originating from the left coronary aortic cusp." EP Europace 19, suppl_3 (June 2017): iii376. http://dx.doi.org/10.1093/ehjci/eux161.044.

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23

Wnuk-Wojnar, A. M., C. Czerwinski, A. Hoffmann, S. Nowak, E. Konarska-Kuszewska, D. Urban'Czyk, J. Krauze, and M. Trusz-Gluza. "A37-3 Linear ablation during sinus rhythm for life-threatening ventricular tachycardia in patients with ischemic cardiomyopathy using CARTO system." EP Europace 4, Supplement_2 (December 1, 2003): B57. http://dx.doi.org/10.1016/eupace/4.supplement_2.b57-b.

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WNUKWOJNAR, A. "35 Ablation treatment for life-threatening ventricular tachycardia in patients with heart failure due to ischemic cardiomyopathy using carto system." European Journal of Heart Failure Supplements 3, no. 1 (June 2004): 6. http://dx.doi.org/10.1016/s1567-4215(04)90017-3.

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Kany, Shinwan, and Ardan M. Saguner. "Die Rolle des elektroanatomischen Mappings in der Rhythmologie." Praxis 107, no. 24 (November 2018): 1325–31. http://dx.doi.org/10.1024/1661-8157/a003129.

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Zusammenfassung. Das Vorhofflimmern ist die häufigste Arrhythmie des Menschen, deren Prävalenz sich in den nächsten Jahren voraussichtlich verdreifachen wird. Die Katheterablation mittels Pulmonalvenenisolation (PVI) verspricht beim symptomatischen Patienten den grössten Therapieerfolg. Die PVI gehört in der Rhythmologie zu den komplexeren Eingriffen. Während es früher bei solchen komplexen Ablationen zu langen Prozedurdauern, Durchleuchtungszeiten und hohen Strahlendosen kam, kann dies heute mit dem dreidimensionalen (3-D) elektroanatomischen Mapping (EAM) in wesentlich kürzerer Zeit mit weniger bis teilweise ganz ohne Röntgenstrahlung erfolgen. Daher hat sich die EAM-gestützte Katheterablation als Standardverfahren bei komplexeren Ablationen etabliert. Die gängigen Systeme sind CARTO®, EnSite NavX® und Rhythmia®. Diese nutzen magnetische Felder und Impedanzverfahren, um Katheter im Herzen zu lokalisieren. Es können dabei 3-D-Landkarten der jeweiligen Herzkammer mittels lokaler Elektrogramme erzeugt werden. Diese Landkarten enthalten Informationen über die Herzanatomie, Voltage (Spannung des Myokards) und elektrische Aktivierung, was in Echtzeit dargestellt werden kann. Daten aus bildgebenden Verfahren wie CT, MRI und Echokardiografie können mit der 3-D-EAM-Karte verschmolzen werden, was die anatomische Genauigkeit des EAM verbessern kann.

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Vitali-Serdoz, L., D. Bastian, S. Poli, J. Walascheck, M. Brunelli, P. Richter, J. Schwab, H. Rittger, M. Pauschinger, and K. Göhl. "073_17092p Effects Of Ensite Navx/Precision™ Compared To Carto®3 On Fluoroscopy Exposure And Procedural Duration In Avnrt Catheter Ablation." JACC: Clinical Electrophysiology 3, no. 10 (October 2017): S3. http://dx.doi.org/10.1016/j.jacep.2017.09.016.

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27

Serafini, Nicholas, Parikshit Sharma, Richard Trohman, and Henry Huang. "ELECTROANATOMIC GUIDED BIVENTRICULAR IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR IMPLANTATION UTILIZING CARTO 3 AND ENSITE NAVX MAPPING SYSTEMS FOR REDUCTION OF FLOUROSCOPY AND INTRAVENOUS CONTRAST USAGE." Journal of the American College of Cardiology 71, no. 11 (March 2018): A450. http://dx.doi.org/10.1016/s0735-1097(18)30991-4.

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Huang, Xingfu, Yanjia Chen, Zheng Huang, Liwei He, Shenrong Liu, Xiaojiang Deng, Yongsheng Wang, Rucheng Li, Dingli Xu, and Jian Peng. "Catheter radiofrequency ablation for arrhythmias under the guidance of the Carto 3 three-dimensional mapping system in an operating room without digital subtraction angiography." Medicine 97, no. 25 (June 2018): e11044. http://dx.doi.org/10.1097/md.0000000000011044.

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Dzhaffarova, O. Yu, L. I. Svintsova, I. V. Plotnikova, S. N. Krivolapov, and E. O. Kartofeleva. "Assessment of the potential damaging effect of radiofrequency exposure in children in prospective follow-up (case report series)." Siberian Journal of Clinical and Experimental Medicine 35, no. 3 (October 17, 2020): 116–24. http://dx.doi.org/10.29001/2073-8552-2020-35-3-116-124.

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Aim: To evaluate the electrical activity of the myocardium and the radiofrequency (RF) application zone resulting from radiofrequency ablation (RFA) performed at an early age.Material and Methods. A prospective follow-up study included three patients who underwent intracardiac electrophysiological study (EPS) and effective RFA of the tachycardia for the first time at an early age. A reintervention was required in one case 12 years after the procedure and in two cases six years after it due to recurrent and new-onset arrhythmias. During the reintervention, electroanatomical mapping was performed to assess the potential damaging effect of radiofrequency exposure in the area of the first ablation.Results. The intracardiac EPS and amplitude bipolar CARTO-reconstruction of primary ablation area were performed during repeated RFA procedure. The study showed that neither zones with a decrease in the amplitude of electrical signal from the myocardium nor silent electrical zones were present ruling out the cicatricial-sclerotic changes in the myocardium in children in the long-term period after RF exposure.Conclusion. The study showed that no increase in the coagulation necrosis zone in the area of primary ablation occurred during the growth of child when the sparing energy and temperature parameters of RFA and the limited number of RF applications were used. Further research in this area is required.

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Khaykin, Yaariv, Richard Oosthuizen, Lauren Zarnett, Zaev A. Wulffhart, Bonnie Whaley, Carol Hill, David Giewercer, and Atul Verma. "CARTO-guided vs. NavX-guided pulmonary vein antrum isolation and pulmonary vein antrum isolation performed without 3-D mapping: effect of the 3-D mapping system on procedure duration and fluoroscopy time." Journal of Interventional Cardiac Electrophysiology 30, no. 3 (January 21, 2011): 233–40. http://dx.doi.org/10.1007/s10840-010-9538-9.

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Yue, Li, Liu Fan, Yang Xiuchun, and Lu Jingchao. "GW25-e4373 Comparative study of Carto-3 system mapping and conventional fluoroscopic mapping by radiofrequency catheter ablation in the treatment of tachyarrhythmia with right-side pathways." Journal of the American College of Cardiology 64, no. 16 (October 2014): C164. http://dx.doi.org/10.1016/j.jacc.2014.06.755.

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Budzianowski, Jan, Jarosław Hiczkiewicz, Katarzyna Łojewska, Edyta Kawka, Rafał Rutkowski, and Katarzyna Korybalska. "Predictors of Early-Recurrence Atrial Fibrillation after Catheter Ablation in Women and Men with Abnormal Body Weight." Journal of Clinical Medicine 10, no. 12 (June 18, 2021): 2694. http://dx.doi.org/10.3390/jcm10122694.

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Our study aimed to select factors that affect the rate of early recurrence (up to 3 months) of atrial fibrillation (AF) (ERAF) following pulmonary veins isolation (PVI) in obese women and men. The study comprised 114 patients: 54 women (age: 63.8 ± 6.3, BMI 31 ± 4 kg/m2), and 60 men (age: 60.7 ± 6.7; BMI 31 ± 3 kg/m2) with paroxysmal, persistent and long-standing persistent AF. They had been scheduled to undergo cryoballoon (men n = 30; women n = 30) and radiofrequency (RF) ablation (men n = 30; women n = 24) using the CARTO-mapping. The blood was collected at baseline and 24 h after ablation. The rate of ERAF was comparable after cryoballoon and RF ablation and constituted 18% in women and 22% in men. Almost 70 parameters were selected to perform univariate and multivariate analysis and to create a multivariate logistic regression (MLR) model of ERAF in the obese men and women. The MLR analysis was performed by forward stepwise logistic regression with three variables. It was only possible to create the MLR model for the group of obese men. It revealed a poor predictive value with an unsatisfactory sensitivity of 31%. Men with ERAF: smokers (OR 39.25, 95% CI 1.050–1467.8, p = 0.0021), with a higher ST2 elevation (OR 1.68, 95% CI 1.115–2.536, p = 0.0021) who received dihydropyridine calcium channel blockers (OR 0.042, 95% CI 0.002–1.071, p = 0.0021) less frequently. Our results indicate a complex pathogenesis of ERAF dependent on the patients’ gender.

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Wang, Yu-Chuan, Bo Huang, Kang Li, Peng-Kang He, Er-Dong Chen, Yu-Long Xia, Jie Jiang, Qin-Hui Sheng, Jing Zhou, and Yan-Sheng Ding. "A Pilot Study on Parameter Setting of VisiTag™ Module during Pulmonary Vein Isolation." Cardiology Research and Practice 2018 (October 29, 2018): 1–5. http://dx.doi.org/10.1155/2018/8960941.

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Objectives. To identify optimal predefined criteria (OPC) for filters of the VisiTag™ module in the CARTO 3 system during pulmonary vein isolation (PVI). Methods. Thirty patients with atrial fibrillation (AF) who experienced PVI first were enrolled. PVI was accomplished by using a Thermocool SmartTouch catheter. Ablation lesions were tagged automatically as soon as predefined criteria of the VisiTag™ module were met. OPC should be that ablation with the setting resulting in the conduction gap (CG) as few as possible, while contiguous encircling ablation line (CEAL) without the tag gap (TG) on the 3D anatomic model as much as possible. Result(s). When ablation with parameter setting is being catheter movement with a 3 mm distance limit for at least 20 s and force over time (FOT) being off, there were 60 CEAL without TG on the 3D anatomic model. However, 26 CGs were found. After changing FOT setting to be a minimal force of 5 g with 50% stability time, 22 TGs were displayed. Of them, 20 TGs were accompanied by CGs. On reablation at sites of TG with changed parameter setting, 18 CGs were eliminated when 20 TGs disappeared. When reablation with FOT is being a minimal force of 10 g with 50% stability time, 6 remaining CGs were eliminated. However, there was no CEAL. With a mean of follow-up 10.93 months, 2 patients with persistent AF suffered AF recurrence. Conclusion. A 3 mm distance limit for at least 20 s and FOT being a minimal force of 5 g with 50% stability time might be OPC for the VisiTag™ module.

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Okumura, Yasuo, Ichiro Watanabe, Kazuki Iso, Koichi Nagashima, Kazumasa Sonoda, Naoko Sasaki, Rikitake Kogawa, et al. "Clinical utility of automated ablation lesion tagging based on catheter stability information (VisiTag Module of the CARTO 3 System) with contact force-time integral during pulmonary vein isolation for atrial fibrillation." Journal of Interventional Cardiac Electrophysiology 47, no. 2 (June 9, 2016): 245–52. http://dx.doi.org/10.1007/s10840-016-0156-z.

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Olivares Sandoval, Omar. "Rivadeneira Velásquez, R. (2010), Macrocosmum carto-graphica. El arte de la cartografía (Notas de clase, diez), Universidad Nacional de Colombia, Facultad de Artes, Bogotá, 125 p., ISBN 978-958-719-673-3." Investigaciones Geográficas, no. 77 (April 9, 2012): 136. http://dx.doi.org/10.14350/rig.31026.

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Herczeg, Szilvia, Joseph Galvin, John J. Keaney, Edward Keelan, Roger Byrne, Claire Howard, Laszlo Geller, and Gabor Szeplaki. "The Value of Voltage Histogram Analysis Derived Right Atrial Scar Burden in the Prediction of Left Atrial Scar Burden." Cardiology Research and Practice 2020 (August 13, 2020): 1–7. http://dx.doi.org/10.1155/2020/3981684.

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Introduction. Growing evidence suggests that fibrotic changes can be observed in atrial fibrillation (AF) in both atria. Quantification of the scar burden during electroanatomical mapping might have important therapeutic and prognostic consequences. However, as the current invasive treatment of AF is focused on the left atrium (LA), the role of the right atrium (RA) is less well understood. We aimed to characterize the clinical determinates of the RA low-voltage burden and its relation to the LA scaring. Methods. We have included 36 patients who underwent catheter ablation for AF in a prospective observational study. In addition to LA mapping and ablation, high-density RA bipolar voltage maps (HD-EAM) were also reconstructed. The extent of the diseased RA tissue (≤0.5 mV) was quantified using the voltage histogram analysis tool (CARTO®3, Biosense Webster). Results. The percentage of RA diseased tissue burden was significantly higher in patients with a CHA2DS2-VASc score ≥ 2 p=0.0305, higher indexed LA volume on the CTA scan and on the HD‐EAM (p=0.0223 and p=0.0064, respectively), or higher indexed RA volume on the HD‐EAM p=0.0026. High RA diseased tissue burden predicted the presence of high LA diseased tissue burden (OR = 7.1, CI (95%): 1.3–38.9, p=0.0145), and there was a significant correlation of the same (r = 0.6461, p<0.0001). Conclusions. Determining the extent of the right atrial low-voltage burden might give useful clinical information. According to our results, the diseased tissue burden correlates well between the two atria: the right atrium mirrors the left atrium.

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Herczeg, Szilvia, John J. Keaney, Edward Keelan, Claire Howard, Katie Walsh, Laszlo Geller, Gabor Szeplaki, and Joseph Galvin. "Classification of Left Atrial Diseased Tissue Burden Determined by Automated Voltage Analysis Predicts Outcomes after Ablation for Atrial Fibrillation." Disease Markers 2021 (June 22, 2021): 1–8. http://dx.doi.org/10.1155/2021/5511267.

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Background. The burden and persistence of atrial fibrillation (AF) have been associated with the presence and extent of left atrial (LA) fibrosis. Recent reports have implicated an association between the extent of LA fibrosis and the outcome of pulmonary vein isolation (PVI). We aimed to analyse the value of an automated scar quantification method in the prediction of success following PVI. Methods. One hundred and nine consecutive patients undergoing PVI for paroxysmal or persistent AF were included in our observational study with a 2-year follow-up. Prior to PVI, patients underwent high-definition LA electroanatomical mapping, and scar burden was quantified by automated software (Voltage Histogram Analysis, CARTO 3, Biosense Webster), then classified into 4 subgroups (Dublin Classes I-IV). Recurrence rates were analysed on and off antiarrhythmic drug therapy (AAD), respectively. Results. The overall success rate was 74% and 67% off AAD at 1- and 2-year follow-up, respectively. Patients with Dublin Class IV had significantly lower success rates ( p = 0.008 , off AAD). Dublin Class IV ( OR = 2.27 , p = 0.022 , off AAD) and the presence of arrhythmia in the blanking period ( OR = 3.28 , p = 0.001 , off AAD) were the only significant predictors of recurrence. The use of AAD did not affect these results. Conclusions. We propose a classification of low voltage areas based on automated quantification by software during 3D mapping prior to PVI. Patients with high burden of low voltage areas (>31% of <0.5 mV, Dublin Class IV) have a higher risk of recurrence following PVI. Information gathered during electroanatomical mapping may have important prognostic value.

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Liu, Changcheng, Zhaoping Su, Liangshan Wang, Bo Li, Jin Wang, Yang Yu, and Chengxiong Gu. "Surgical Endoepicardial Linear Ablation for Ventricular Tachycardia With Postinfarction Left Ventricular Aneurysm." Texas Heart Institute Journal 47, no. 3 (June 1, 2020): 194–201. http://dx.doi.org/10.14503/thij-18-6615.

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This retrospective study evaluated the feasibility of surgical endoepicardial linear ablation for ventricular tachycardia in patients with postinfarction left ventricular aneurysm. Sixty-four patients with multivessel coronary artery disease and left ventricular aneurysm but no mural thrombosis of the aneurysm or valve disease were treated at our institution from March 2012 through July 2015. All underwent off-pump coronary artery bypass grafting and left ventricular aneurysm repair by linear plication. Twenty-three patients (35.9%) had ventricular tachycardia and underwent surgical endoepicardial linear ablation on the beating heart guided by epicardial substrate mapping with the Carto 3 system. The remaining 41 patients (64.1%) composed the no-ablation group. The effectiveness of surgical linear ablation in the ablation group was evaluated. Safety and clinical outcomes were evaluated and compared between the groups. The ventricular tachycardia recurrence rate in the ablation group was 17.4% in the immediate postoperative period and 23.8% at last follow-up (39 ± 21 mo). Early (<30-d) mortality rates were 8.7% in the ablation group and 4.9% in the no-ablation group (P=0.41); the respective late mortality rates were 19.1% and 18% (P=0.70). Multivariate Cox regression analysis indicated that preoperatively poor left ventricular function was an independent risk factor for early and late death in both groups. The groups were similar in terms of the need for postoperative mechanical circulatory support, intensive care unit stay, and cumulative survival rate. We conclude that, for carefully selected candidates, surgical endoepicardial linear ablation combined with off-pump coronary artery bypass grafting and left ventricular aneurysm linear plication is a feasible treatment for ventricular tachycardia with postinfarction left ventricular aneurysm.

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Bezerra, Evandro D., Jordan Gauthier, Alexandre V. Hirayama, Barbara S. Pender, Reed M. Hawkins, Aesha Vakil, Rachel N. Steinmetz, et al. "Factors Associated with Response, CAR-T Cell In Vivo Expansion, and Progression-Free Survival after Repeat Infusions of CD19 CAR-T Cells." Blood 134, Supplement_1 (November 13, 2019): 201. http://dx.doi.org/10.1182/blood-2019-123807.

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Background CD19-targeted chimeric antigen receptor-engineered (CD19 CAR)-T cell immunotherapy has shown promising efficacy in patients with relapsed or refractory (R/R) B-cell malignancies. The potential benefits of repeat infusions of CD19 CAR-T cells are unknown, and the factors associated with response, CAR-T cell in vivo expansion, and progression-free survival (PFS) after repeat infusion of CD19 CAR-T cells have not been investigated. Methods We analyzed the outcomes of patients with R/R B-cell malignancies after a second infusion of CD19 CAR-T cells (CART2) on a phase 1/2 trial (NCT01865617) at our institution. Responses after CAR-T cell therapy were evaluated around day 28 after infusion and defined according to the 2018 NCCN guidelines for acute lymphoblastic leukemia (ALL), 2018 iwCLL for chronic lymphocytic leukemia (CLL), and the Lugano criteria for non-Hodgkin lymphoma (NHL). Logistic, Cox and linear regression were used for multivariable analyses of response, progression-free survival and peak CD8+ CAR-T in blood, respectively. Bayesian model averaging was performed for variable selection. Results Forty-four patients evaluable for response (ALL, n=14; CLL, n=11; NHL, n=19) were included in this study. The median age at the time of CART2 was 58 (range, 23-73). Patients were heavily pre-treated (median prior therapies, 6; range, 2-13), and 16 patients (36%) had bulky (≥ 5cm) nodal or extramedullary disease. The median time from the first CAR-T infusion (CART1) to CART2 was 70 days (range, 28-712). Twenty-eight patients (64%) had received a CART1 dose ≥ 2x106 CAR-T cells/kg. Fifteen patients (32%) had not responded to CART1, 22 (50%) relapsed or progressed after having initially responded (complete response [CR], n=15; partial response [PR], n=7) to CART1; 7 (16%) received CART2 in PR after CART1. All characteristics are shown in the Table. We observed responses in all disease types, including 3 of 14 ALL patients (21%; all CR/CRi), 4 of 11 CLL patients (36%; CR/CRi, n=3; partial response [PR], n=1), and 9 of 19 NHL patients (47%; CR, n=2; PR, n=7). After a median follow-up of 43 months (range, 16-66) in alive and responding patients, the estimated 4-year PFS probability in responders was 23% (95% CI, 9-59%). The 4-year overall survival probability in responders was 36% (95% CI 19-71%) compared to 24% (95% CI, 12-47) in non-responders. Multivariable logistic regression modeling identified predictors of response after CART2: CART1 lymphodepletion (high-intensity cyclophosphamide and fludarabine [CyFlu] vs no CyFlu, OR=12.19, 95% CI, 1.10-1689.85, p=0.04), and peak of in vivo CAR-T cell expansion after CART2 (OR=2.31 per log10 CD8+ CAR-T cell/µL increase, 95% CI, 1.17-5.29, p=0.01). In a multivariable Cox model, a higher peak of CD8+ CAR-T cells after CART2 (HR=0.47 per log10 CD8+ CAR-T cell/µL increase, 95%CI, 0.33-0.68, p<0.001); CART2 > CART1 cell dose was associated with longer PFS (HR=0.36, 95% CI, 0.16-0.86, p=0.02). This suggested that CD8+ CAR-T cell peak after CART2 and factors increasing CART2 peak (e.g. prevention of immune rejection or increase in the infused cell dose) are key elements associated with outcomes of CART2. Hence, we looked at factors associated with higher CD8+ CART2 peak. In multivariable linear regression, CART1 CyFlu predicted a higher peak of CD8+ CAR-T cells after CART2 (high-intensity CyFlu vs no CyFlu, p<0.001 ; low-intensity CyFlu versus no CyFlu, p=0.002) after adjusting for disease type (CLL vs ALL, p=0.02; NHL vs ALL, p=0.04) and the total CD19+ cell count in blood (p=0.02). CyFlu being the most commonly used lymphodepletion prior to CAR-T cell therapy, we evaluated the impact of CART1 CyFlu lymphodepletion intensity by comparing high-intensity to low-intensity CyFlu in our multivariable models. Logistic regression suggested higher probabilities of response to CART2 in patients who received high-intensity compared to low-intensity CyFlu prior to CART1 (OR=3.83, 95%CI, 0.85-21.83, p=0.08). In multivariable analysis, CART1 high-intensity CyFlu was associated with higher CD8+ CAR-T cell numbers at day 60 after CART2 compared to low-intensity CyFlu (p=0.01) after adjusting for disease type and total CD19+ cell count in the blood. Conclusion Our findings suggest outcomes after second infusions of CD19 CAR-T cells might be improved with high-intensity CyFlu lymphodepletion prior to CART1 and by increasing the CAR-T cell dose at the time of CART2. Table Disclosures Hirayama: DAVA Oncology: Honoraria. Till:Mustang Bio: Patents & Royalties, Research Funding. Kiem:Rocket Pharma: Consultancy, Equity Ownership; Homology Medicines: Consultancy, Equity Ownership; CSL Behring: Consultancy; Magenta Therapeutics: Consultancy. Shadman:Mustang Biopharma: Research Funding; Gilead: Research Funding; Bigene: Research Funding; AstraZeneca: Consultancy; Merck: Research Funding; Atara: Consultancy; AbbVIe: Consultancy, Research Funding; Genentech, Inc.: Consultancy, Research Funding; TG Therapeutics: Research Funding; Sound Biologics: Consultancy; Pharmacyclics: Consultancy, Research Funding; ADC Therapeutics: Consultancy; Verastem: Consultancy; Celgene: Research Funding; Acerta: Research Funding; Emergent: Research Funding; Sunesis: Research Funding. Cassaday:Amgen: Consultancy, Research Funding; Pfizer: Consultancy, Honoraria, Research Funding; Incyte: Research Funding; Kite/Gilead: Research Funding; Merck: Research Funding; Seattle Genetics: Research Funding; Seattle Genetics: Other: Spouse's disclosure: employment, stock and other ownership interests. Riddell:Juno Therapeutics: Equity Ownership, Patents & Royalties, Research Funding; Adaptive Biotechnologies: Consultancy; Lyell Immunopharma: Equity Ownership, Patents & Royalties, Research Funding. Maloney:BioLine RX, Gilead,Genentech,Novartis: Honoraria; Juno Therapeutics: Honoraria, Patents & Royalties: patients pending , Research Funding; Celgene,Kite Pharma: Honoraria, Research Funding; A2 Biotherapeutics: Honoraria, Other: Stock options . Turtle:Precision Biosciences: Equity Ownership, Membership on an entity's Board of Directors or advisory committees; Eureka Therapeutics: Equity Ownership, Membership on an entity's Board of Directors or advisory committees; Juno Therapeutics: Patents & Royalties: Co-inventor with staff from Juno Therapeutics; pending, Research Funding; Caribou Biosciences: Equity Ownership, Membership on an entity's Board of Directors or advisory committees; Kite/Gilead: Other: Ad hoc advisory board member; Allogene: Other: Ad hoc advisory board member; Nektar Therapeutics: Other: Ad hoc advisory board member, Research Funding; T-CURX: Membership on an entity's Board of Directors or advisory committees; Novartis: Other: Ad hoc advisory board member; Humanigen: Other: Ad hoc advisory board member.

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Rillo, Mariano, Pompeo E. Maggio, Angelo Aloisio, and Davide Aloisio. "Follow up a lungo termine dell’ablazione ibrida della fibrillazione atriale persistente o persistente di lunga durata con tecnica Convergent: la prima esperienza in Italia." Cardiologia Ambulatoriale, no. 2 (September 30, 2020): 88–101. http://dx.doi.org/10.17473/1971-6818-2020-2-2.

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Introduzione: I dati a lungo termine del follow up dei pazienti (pz) sottoposti ad ablazione (A) transcatetere con radiofrequenza (RF) endocardica (Endo) della fibrillazione atriale (FA) persistente (P) o di lunga durata (LD) si sono dimostrati meno incoraggianti rispetto a quelli ottenuti per la FA parossistica. Recentemente una tecnica ibridadi A epicardica (Epi) e Endo, ha dimostrato di essere più efficace della sola A-Endo. Scopo: lo scopo del nostro studio è stato quello di riferire la nostra esperienza nell’esecuzione di questo approccio. Metodi e risultati: 15 pz con FAP (11) o FAP-LD (4), 9 maschi e 6 femmine, età media 67 ± 7 anni, precedentemen-te trattati senza successo con singola (10 pz) o multiple (5 pz) sessioni di A-Endo sono stati sottoposti a A-Epi per silenziare l’atrio sinistro posteriore (ASP). Un mese dopo l’A-Epi abbiamo eseguito una A-Endo per cercare even-tuali aree residue delle vene polmonari (VP) o dell’ASP che avrebbero potuto richiedere un ulteriore trattamento. Inoltre, abbiamo eseguito una mappabipolare ad alta densità utilizzando il sistema CARTO 3D, con acquisizione di almeno 2.000 punti al fine di identificare la fibrosi al di fuori dell’ASP. L’A-Epi ha richiesto un numero di righe di linee di ablazione di 1 in 3 pz (20%) e 2 in 12 pz (80%), con una media di 9 ± 3 linee nella riga inferiore e 7 ± 1 nella superiore. In un solo pz abbiamo osservato versamento pericardico ed è stato l’unico fallimento della nostra serie. l’A-Endo ha dimostrato 19 gaps di conduzione che hanno interessato 4 VP nel 21,4% dei pz e 41 gaps dell’ASP nel 71,4% dei pz. La fibrosi al di fuori dell’ASP è stata osservata in 6 pz. Non sono stati rilevati episodi di FA nell’84,6% dei pz al diciottesimo mese di follow-up; il 30.8% dei pz è stato trattato con Amiodarone. Conclusioni: l’A-Epi e l’A-Endo si sono dimostrate efficaci per il trattamento della FAP o FAP-LD con un rischio accettabile di complicanze, sebbene il numero limitato di casi e la natura osservazionale dello studio richiedano cautela nelle conclusioni.

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Mahdavi Amiri, Ali, Troy Alderson, and Faramarz Samavati. "Geospatial Data Organization Methods with Emphasis on Aperture-3 Hexagonal Discrete Global Grid Systems." Cartographica: The International Journal for Geographic Information and Geovisualization 54, no. 1 (March 2019): 30–50. http://dx.doi.org/10.3138/cart.54.1.2018-0010.

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Ping, Rong-Gang, X. H. Mo, C. D. Fu, K. L. He, J. F. Hu, B. Huang, G. Qin, et al. "Chapter 3 Analysis Tools." International Journal of Modern Physics A 24, supp01 (May 2009): 23–77. http://dx.doi.org/10.1142/s0217751x09046436.

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Ying, Y., Y. P. Lee, H. Pan, and Y. H. Zhang. "Mo-Doping Effect in CaRuO$_{3}$." Journal of the Korean Physical Society 53, no. 9(5) (November 15, 2008): 2363–67. http://dx.doi.org/10.3938/jkps.53.2363.

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"Biosense Webster Carto 3 System." Biomedical Safety & Standards 50, no. 19 (November 1, 2020): 148. http://dx.doi.org/10.1097/01.bmsas.0000720116.61547.92.

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"Carto 3 System Interface Cable." Biomedical Safety & Standards 41, no. 6 (April 2011): 44. http://dx.doi.org/10.1097/01.bmsas.0000395941.05712.56.

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Elices Teja, J., O. Duran Bobin, A. Lopez Lopez, A. Perez Perez, R. Franco Gutierrez, and C. Gonzalez Juanatey. "Pacemaker implantation using electroanatomical mapping system Carto 3: technical protocol, single centre experience." EP Europace 23, Supplement_3 (May 1, 2021). http://dx.doi.org/10.1093/europace/euab116.384.

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Abstract Funding Acknowledgements Type of funding sources: None. Background / Purpose: Three-dimensional electro-anatomical mapping systems (EAM) reduce fluoroscopy exposure during ablation procedures. The aim of this study is to evaluate the security and feasibility of performing pacemaker implantation with EAM routinely on a more regular basis (without fluoroscopy) and to draft a technical protocol to perform these implants. Methods Eight non-selected patients with pacemaker indication that had been referred to the electrophysiology unit of our institution underwent a dual chamber pacemaker implantation with EAM system Carto 3 (Biosense Webster, Irvine, CA, USA). All implants were performed by the same operator and, in all cases, the same lead model was employed. All difficulties that arose during the implantations were solved applying the actions contained in the protocol described below. First - Creation of three anatomical maps with Carto 3: venous access, right atrium and right ventricle. Annotate the end of the venous sheath. Second- For right ventricle lead positioning, connect the pacemaker lead to the Carto 3 system as an external catheter. Place the right ventricle lead, fix it and perform measurements. Third - Fuse the three maps with the "anatomical merge" tool. Fourth - Using the "design line" tool, draw a line from the tip of the lead to the end of the venous sheath following the expected trajectory of the lead in its correct position. Measure that distance. Calculate (substrate) the theoretically remaining lead. Fifth - With a ruler, measure the portion of the lead remaining out of the sheath. Sixth - Reposition the lead, if necessary. Seventh - Repeat the same procedure for the atrial lead and complete the implant procedure. Finally - Verify leads position with fluoroscopy (optional). Results : Eight patients received a dual chamber pacemaker, 75% male with a mean age 82,88 ±4,97 years. The most frequent indication was AV block (75%). The implant was performed through cephalic vein access (37,5%), subclavian vein access (50%). Mean procedure time (skin to skin) was 94 ±15 minutes. There were no complications related to the implant nor was it necessary to replace the lead. Conclusions : Pacemaker implantation with Carto 3 is a safe and reliable. The learning curve is not steep and the operator should be confident enough only after a few procedures. The protocol developed facilitates the implant procedure. Fluoroscopy timeCase12345678Fluoroscopy time (s)474786246060Dose area product (Gy*cm2)4,270,3710,0290,0630,0630,020,1230,018Abstract Figure. Carto image: dual chamber pacemaker.

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KITTNAR, O., L. RIEDLBAUCHOVÁ, T. ADLA, V. SUCHÁNEK, J. TOMIS, M. LOŽEK, A. VALERIÁNOVÁ, et al. "Outcome of Resynchronization Therapy on Superficial and Endocardial Electrophysiological Findings." Physiological Research, December 19, 2018, S601—S610. http://dx.doi.org/10.33549/physiolres.934056.

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Cardiac resynchronization therapy (CRT) has proven efficacious in the treatment of patients with heart failure and dyssynchronous activation. Currently, we select suitable CRT candidates based on the QRS complex duration (QRSd) and morphology with left bundle branch block being the optimal substrate for resynchronization. To improve CRT response rates, recommendations emphasize attention to electrical parameters both before implant and after it. Therefore, we decided to study activation times before and after CRT on the body surface potential maps (BSPM) and to compare thus obtained results with data from electroanatomical mapping using the CARTO system. Total of 21 CRT recipients with symptomatic heart failure (NYHA II-IV), sinus rhythm, and QRSd ≥150 ms and 7 healthy controls were studied. The maximum QRSd and the longest and shortest activation times (ATmax and ATmin) were set in the BSPM maps and their locations on the chest were compared with CARTO derived time interval and site of the latest (LATmax) and earliest (LATmin) ventricular activation. In CRT patients, all these parameters were measured during both spontaneous rhythm and biventricular pacing (BVP) and compared with the findings during the spontaneous sinus rhythm in the healthy controls. QRSd was 169.7±12.1 ms during spontaneous rhythm in the CRT group and 104.3±10.2 ms after CRT (p<0.01). In the control group the QRSd was significantly shorter: 95.1±5.6 ms (p<0.01). There was a good correlation between LATmin(CARTO) and ATmin(BSPM). Both LATmin and ATmin were shorter in the control group (LATmin(CARTO) 24.8±7.1 ms and ATmin(BSPM) 29.6±11.3 ms, NS) than in CRT group (LATmin(CARTO) was 48.1±6.8 ms and ATmin(BSPM) 51.6±10.1 ms, NS). BVP produced shortening compared to the spontaneous rhythm of CRT recipients (LATmin(CARTO) 31.6±5.3 ms and ATmin(BSPM) 35.2±12.6 ms; p<0.01 spontaneous rhythm versus BVP). ATmax exhibited greater differences between both methods with higher values in BSPM: in the control group LATmax(CARTO) was 72.0±4.1 ms and ATmax (BSPM) 92.5±9.4 ms (p<0.01), in the CRT candidates LATmax(CARTO) reached only 106.1±6.8 ms whereas ATmax(BSPM) 146.0±12.1 ms (p<0.05), and BVP paced rhythm in CRT group produced improvement with LATmax(CARTO) 92.2±7.1 ms and ATmax(BSPM) 130.9±11.0 ms (p<0.01 before and during BVP). With regard to the propagation of ATmin and ATmax on the body surface, earliest activation projected most often frontally in all 3 groups, whereas projection of ATmax on the body surface was more variable. Our results suggest that compared to invasive electroanatomical mapping BSPM reflects well time of the earliest activation, however provides longer time-intervals for sites of late activation. Projection of both early and late activated regions of the heart on the body surface is more variable than expected, very likely due to changed LV geometry and interposed tissues between the heart and superficial ECG electrode.

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Baskaran, Abhishek, Einat Shapira, Ahmed Niri, Stéphane Massé, Andrew Ha, Meir Bartal, Tal Baron, Gal Hayam, and Kumaraswamy Nanthakumar. "Abstract 14246: Automated Detection of Arrhythmogenic VT Substrate: Performance of a 2019 HRS VT Consensus Document Recommended Strategy." Circulation 142, Suppl_3 (November 17, 2020). http://dx.doi.org/10.1161/circ.142.suppl_3.14246.

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Background: During ventricular tachycardia (VT) ablation, clinical VT is often non-inducible or hemodynamically unstable. Hence, a substrate-based approach is often necessary. Although many strategies have been proposed, none have been automated nor incorporated into current day electro-anatomical mapping (EAM) systems. One strategy, recommended in 2019 HRS guideline, is Decrement Evoked Potential (DeEP) mapping for identification of critical VT substrate. We have developed an automated method to identify critical DeEP VT substrate in an EAM system (CARTO ® 3). Objective: The performance of this novel automated algorithm was retrospectively evaluated in patients who underwent substrate-based VT ablation. Methods: Entire VT ablation using DeEP mapping was performed and recorded in 12 consecutive patients. CARTO ® 3 case data was downloaded and analyzed by a novel automated algorithm for DeEP detection. A blinded electrophysiologist verified the automated electrogram DeEP annotations and assessed its performance in a dichotomous fashion. The effect of bipolar voltage threshold (0.01, 0.02, 0.05, 0.075, 0.1, 0.20, 0.25 and 0.30 mV) on algorithm performance was evaluated. Sensitivity, specificity and ROC curve of the algorithms were calculated. Finally, results from the analysis were merged with voltage map to produce DeEP maps. Results: Results from the ROC curve shows that a bipolar threshold of 0.075mV optimizes specificity and sensitivity. At that threshold the algorithm found 848 true positive and 626 true negatives out of a total of 1975 EGMS being analyzed. Sensitivity and specificity were found to be 65.8% and 82.3% respectively. Conclusions: We have developed an automatic detection algorithm that identifies and locates critical VT substrates. The performance characteristics have been evaluated for a multimodal VT substrate map to provide clinicians mechanistic substrate map in CARTO 3 ® for VT ablation.

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Hummel, John D., Ziad Zeidan, Steven J. Kalbfleisch, Mahmoud Houmsse, Ralph Augostini, Raul Weiss, and Emile Daoud. "Abstract 16695: Rapid Activation Patterns Identified by Computational Analysis of Multielectrode Endocardial Recordings During Atrial Fibrillation in Humans." Circulation 130, suppl_2 (November 25, 2014). http://dx.doi.org/10.1161/circ.130.suppl_2.16695.

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Introduction: Computational analysis of 64-electrode basket catheter (BC) recordings of atrial fibrillation (AF) have been used to generate visually-identified electrical rotors and focal sources that are then targeted for radiofrequency ablation (RFA). Hypothesis: The purpose of this study was to assess BC maps of right (RA) and left (LA) atria during AF in humans using a novel software, CartoFinder™ (CF) (Biosense Webster, CA, USA), which was developed to identify rapid activation patterns (RAP) and incorporate them into a 3D mapping system, CARTO. Methods: 20 patients who were undergoing RFA AF utilizing CARTO mapping and who consented were enrolled. 1 minute BC maps of the RA and LA were obtained after creation of a 3D virtual anatomic shell prior to and after RFA around the pulmonary veins (PV). There were no complications. BC maps were analyzed by CF post procedure. CF annotates the leading edge of RAP with red color (see figure). Results: Of these 20 patients, CF recordings were complete in 14 pts (mean age 59; 12 persistent AF). There were 2.8 RAP / pt. The RA RAP were located septum (n = 9), anterolateral (n=5), and posterior (n = 3) walls. The LA RAP were located anterior (n = 8), roof (n=7), and posterior (n = 7) walls. RFA was delivered on top of (n=10), within 5mm (n = 4), or distant (n=10) from any RAP. Post PV isolation, there was a 45% reduction in RAP vs pre-RFA; and, 11 pts converted to sinus (n=7) or transitioned to flutter (n=4). Conclusions: CF is a novel software algorithm incorporated into CARTO that identifies RAP in the RA and LA. RFA around the PV only results in 45% reduction of RAP, suggesting that RFA beyond traditional PV isolation is required to eliminate the bulk of RAP.

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Yu, Long, Steve Pogwizd, Hugh T. McElderry, Ting Yang, and Bin He. "Abstract 18237: Non-invasive Three Dimensional Imaging of Ventricular Arrhythmias: In-procedure Simultaneous Mapping of Ventricular Tachycardia and Premature Ventricular Complexes." Circulation 132, suppl_3 (November 10, 2015). http://dx.doi.org/10.1161/circ.132.suppl_3.18237.

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Introduction: Noninvasive activation imaging and the identification of initiation sites or reentrant circuits are highly desirable for aiding catheter ablative treatment of ventricular arrhythmia. While approaches are being developed to image epicardial potential, Cardiac Electrical Sparse Imaging (CESI), a 3-dimensional noninvasive activation imaging technique offers insight into intramural activation. In this study, we report the first clinical study of the CESI technique with in-procedure simultaneous mapping of Ventricular Tachycardia (VT) and Premature Ventricular Complexes (PVCs). Methods: Body surface potential maps (BSPMs) were recorded using 170±9 electrodes in 4 patients (2 males, 2 females, age 53±5) with VT and/or PVC in the EP lab simultaneously with CARTO mapping and ablation. CT or MRI images were obtained for individualized volume conductor modeling. Activation sequences were estimated using CESI upon the 40 isolated PVC or VT beats induced by programmed stimulation or isoproterenol infusion. Imaging results were compared with CARTO map and ablation sites/outcomes. Results: Good concordance was observed between the imaged results and the EP study. A Correlation Coefficient of 0.76±0.04 and Relative Error of 0.22±0.05 were found between the imaged activation sequences and the Local Activation Time maps from CARTO. The imaged initiation sites well co-localized with the ablation outcomes with Localization Error of 8±1.3mm from the last ablation site and 3.3±1.7mm from the nearest ablation site. Conclusions: We demonstrate for the first time that the beat-to-beat 3D activation imaging technique CESI can be applied clinically with simultaneous mapping in the EP lab. The noninvasive imaging results are in good agreement with the EP study and catheter ablation outcome. The promising results suggest CESI warrants further investigation and has the potential to become a clinically useful technology guiding ablation procedures in patients.

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