B-PO01-090 PROSPECTIVE ASSESSMENT OF AN AUTOMATED INTRAPROCEDURAL ECG-BASED SYSTEM FOR LOCALIZING VT EXIT SITES IN PATIENTS WITH STRUCTURAL HEART DISEASE (SHD)

Abstract

We have previously developed an intraprocedural automatic arrhythmia origin localization (AAOL) system to localize idiopathic ventricular arrhythmia origins onto patient-specific electroanatomic (EAM) surface in real time using a 3-lead ECG. To assess the localization accuracy of ventricular tachycardia (VT) exit and premature ventricular complex (PVC) origin sites in patients with SHD using the AAOL system. In retrospective and prospective cohorts, a total of 42 patients who underwent VT/PVC ablation in the setting of SHD were recruited at two different centers. The AAOL system combines 120-ms QRS integrals of 3 leads (III, V2, V6) with pace mapping to predict VT exit/PVC origin site and projects that site onto the patient-specific electroanatomic surface. VT exit/PVC origin sites were clinically identified by contact mapping. The localization error of the VT exit/PVC origin site was assessed by the distance between the clinically identified site and the estimated site. In the retrospective cohort of 19 patients with SHD, the AAOL system achieved a mean localization accuracy of 6.5±2.6mm for 25 induced VTs. In the prospective cohort with 23 patients, mean localization accuracy was 5.9±2.6mm for 26 VT exit and PVC origin sites (Figure 1). There was no difference in mean localization error in epicardial sites compared to endocardial sites using the AAOL system (6.0 vs. 5.8 mm, P =0.895). Figure 1 shows an example of VT exit site localization. The AAOL system achieved accurate localization of VT exit/PVC origin sites in patients with SHD that is superior to current system, which supports the potential clinical utility.