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Concordance and reliability between electroanatomical mapping using high density mapping catheter and ADAS-3D software for myocardial tissue characterization in non-ischemic cardiomyopathy patients

Title: Concordance and reliability between electroanatomical mapping using high density mapping catheter and ADAS-3D software for myocardial tissue characterization in non-ischemic cardiomyopathy patients
Authors: D Angelo, L; Compagnucci, P C; Volpato, G V; Parisi, Q P; Cipolletta, L C; Valeri, Y V; Campanelli, F C; Finori, L F; Guerra, F G; Pelargonio, G P; Dello Russo, A D R; Narducci, M L N; Casella, M C
Source: Europace ; volume 27, issue Supplement_1 ; ISSN 1099-5129 1532-2092
Publisher Information: Oxford University Press (OUP)
Publication Year: 2025
Description: Introduction Risk assessment for ventricular arrhythmias (VAs) and sudden cardiac death (SCD) in non-ischemic cardiomyopathy (NICM) is a clinical challenge. Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) is the gold standard for identifying scar core zone (CZ) and border zones (BZ), the primary substrates for VA. The ADAS 3D software (GALGO Medical) processes LGE-CMR data to map CZ and BZ distribution across myocardial segments, from endocardium (ENDO) to the epicardium (EPI). For patients unable to undergo LGE-CMR, myocardial tissue characterization may alternatively be achieved via electroanatomical mapping (EAM) using a high-density mapping catheter equipped with omnipolar technology (OT) to delineate scar regions and their electrophysiological profiles. Purpose To assess the concordance and reliability of myocardial tissue characterization between ADAS 3D and EAM performed with a high-density mapping catheter using OT. Method In this multicentric retrospective observational study, we included 36 NICM patients who underwent left ventricular (LV) EAM for arrhythmia and SCD risk assessment, all of whom had prior LGE-CMR imaging. ADAS 3D processed the LGE-CMR data to generate color-coded pixel intensity maps of CZ and BZ, illustrating their extension from the ENDO to EPI layers. EAM was performed with the Ensite X navigation system (ABBOTT) and the Advisor high density Grid mapping catheter (AHD-G, ABBOTT) using OT, bipolar (BIP), and unipolar (UNI) configurations. Concordance between EAM and ADAS 3D in CZ and BZ mapping was evaluated using Cohen's Kappa coefficient for agreement and Bland-Altman analysis for reliability across all EAM modes Results The agreement analysis confirmed the UNI configuration’s capability to explore epicardial regions (Cohen’s Kappa 0.93, p < 0.001; positive predictive value [PPV] 97.2%, negative predictive value [NPV] 86.5%) and demonstrated superior reproducibility of OT over BIP when compared to ADAS 3D in ENDO layers (OT vs BIP: K Cohen 0.97 vs. ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/europace/euaf085.066
Availability: https://doi.org/10.1093/europace/euaf085.066; https://academic.oup.com/europace/article-pdf/27/Supplement_1/euaf085.066/63303633/euaf085.066.pdf
Rights: https://creativecommons.org/licenses/by-nc/4.0/
Accession Number: edsbas.CDD6E10B
Database: BASE