Purpose

The purpose of the study was to investigate the usefulness of the extended early meets late (EEML) feature of the HD Coloring software for confirmation of bidirectional block along an ablation line.

Methods

A single-center prospective observational study of consecutive patients with atypical atrial flutter or persistent atrial fibrillation submitted to catheter ablation including linear lesions from January 2019 to June 2020, with confirmation of bidirectional block across ablation lines assessed with the feature EEML and a multipolar catheter was conducted. Patients were divided into two groups — those with versus those without bidirectional block — and different EEML thresholds were analyzed to assess which one had the better sensitivity and specificity to predict block.

Results

During the 24-month enrollment period, a total of 94 patients were included (50% males, mean age of 64 ± 10 years, 60% with structural heart disease) — 55 patients with versus 39 patients without confirmed a bidirectional block. Activation maps were performed during atrial pacing, with a median number of 1340 (interquartile range 1135–2060) points acquired in 11 ± 3 min, and a mean mapped cycle length of 287 ± 51 ms. The EEML feature was highly useful in detecting bidirectional block along ablation lines, with a 25% threshold value showing the highest discriminative performance (area under the curve of 0.93), 95% sensitivity and 92% specificity in predicting block.

Conclusions

The EEML feature of the HD Coloring software is a useful addition to the CARTO mapping system for assessment of block across an ablation line. The threshold value of 25% is the most accurate.

中文翻译：

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延长早期满足评估沿消融线传导阻滞的延迟

目的

该研究的目的是调查 HD Coloring 软件的扩展早期满足晚期 (EEML) 功能对沿消融线确认双向阻滞的有用性。

方法

一项单中心前瞻性观察研究对 2019 年 1 月至 2020 年 6 月接受导管消融（包括线性病变）的非典型心房扑动或持续性心房颤动的连续患者进行了一项单中心前瞻性观察研究，并确认使用 EEML 和多极导管评估消融线的双向阻滞。实施。将患者分为两组——有双向阻滞的组和没有双向阻滞的组——分析不同的 EEML 阈值，以评估哪一组具有更好的预测阻滞的敏感性和特异性。

结果

在 24 个月的入组期间，共纳入 94 名患者（50% 为男性，平均年龄为 64 ± 10 岁，60% 患有结构性心脏病）——55 名患者与 39 名未确认双向阻滞的患者。在心房起搏期间进行激活图，在 11 ± 3 分钟内获得 1340 个（四分位距 1135-2060）点的中位数，平均映射周期长度为 287 ± 51 毫秒。EEML 特征在检测沿消融线的双向阻滞方面非常有用，25% 的阈值显示出最高的判别性能（曲线下面积为 0.93）、95% 的灵敏度和 92% 的特异性预测阻滞。

结论

HD Coloring 软件的 EEML 功能是对 CARTO 映射系统的有用补充，可用于评估消融线上的阻滞。25% 的阈值是最准确的。