B-PO03-096 DIELECTRIC IMAGING ACCURATELY MEASURES REGIONAL CARDIAC CHAMBER WALL THICKNESS - AN IN VIVO STUDY

Abstract

Left atrial wall thickness is a known determinant of radiofrequency ablation lesion transmurality and previous studies have demonstrated more frequent pulmonary vein reconnection in regions of increased atrial wall thickness. The KODEX-EPD mapping system (EPD Solutions, a Philips company) uses a novel technology, dielectric imaging, to determine wall thickness measurements in real time. To evaluate feasibility of a real-time catheter-based method for measuring myocardial wall thickness in vivo. A pilot study was performed in 4 terminally-anaesthetised swine. Wall thickness measurements of the right atrium and left ventricle were performed using a SmartTouch SurroundFlow Catheter (Biosense Webster) and KODEX-EPD. All pigs underwent pre-procedure contrast enhanced cardiac computed tomography (CT) imaging. CT wall thickness measurements were performed by an expert radiologist blind to the KODEX-EPD data. 48 wall thickness points were measured (30 in the right atrium, 18 in the left ventricle). Wall thickness ranged from 1.9mm to 12.9mm. There was no significant difference in atrial wall thickness between KODEX-EPD and CT (3.02±0.35mm vs. 3.00±0.45mm, P=0.65). Bland-Altman analysis showed no proportional or systematic bias between KODEX-EPD and CT. There was a statistically significant positive correlation between atrial and ventricular wall thickness measured using KODEX-EPD and CT (R=0.85, P<0.05). This pilot study demonstrates feasibility of localised myocardial wall thickness measurement using the KODEX-EPD platform. Further studies are ongoing with a next generation algorithm for application in humans.