What is the Spatial Accuracy of the CARTO PaSo Module? An Independent Computational Geometric Analysis

D Dharmaprani, A Ganesan, A McGavigan

Research output: Contribution to conferenceAbstract

Abstract

Background: The CARTO PaSo module is an important potential advance in quantitative pace mapping in electrophysiology laboratories; however, limited calibration data are available to guide clinicians. Previous studies use only semi-quantitative methods to evaluate spatial accuracy. We develop a novel computational geometric approach to determine pace-mapping accuracy, and apply this method to the PaSo module. Methods: Clinical mapping data were acquired from 17 structurally normal human hearts post–SVT ablation. A paced template was acquired in a single cardiac chamber (seven right ventricle outflow tract, seven right ventricles, and three left ventricles) and compared with 50 pace maps in different regions of the chamber. Quantitative correlation to surface electrocardiogram template was assessed with PaSo. The three-dimensional (3D) geometry triangulated mesh was exported, and spatial accuracy of pace-mapping quantified using (1) the geodesic distance across the 3D mesh, computed with a novel algorithm based on Dijkstra's theorem; and (2) the spatial volume occupied by the convex hull of the 3D point cloud of pace maps. Results: Decreasing PaSo coefficients showed a linear inverse relationship with distance (0.01 unit decrease in PaSo = 1.1 mm increased Cartesian [95% confidence interval {CI} 0.9–1.3; p < 0.001] and 2.4 mm increased geodesic distance [95% CI 1.9–2.9; p < 0.001]). A 0.01 unit increase in PaSo gave 664 mm3 decrease in convex hull volume (95% CI 423–906; p < 0.0001). Human 12-lead matching revealed poorer spatial resolution, with one match decrease giving 1.7 mm increased Cartesian (95% CI 1.5–2.0; p < 0.001), 3.4 mm increased geodesic distance (95% CI 2.8–4.1; p < 0.001), and 712 mm3 increase in convex hull volume (95% CI 599–830; p < 0.0001). Conclusion: The study provides an independent calibration of the spatial accuracy of PaSo using newly developed computational geometric methods.

Conference

Conference66th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, the International Society for Heart Research Australasian Section Annual Scientific Meeting and the 12th Annual Australia and New Zealand Endovascular Therapies Meeting
Abbreviated titleCSANZ2018 ANZET18
CountryAustralia
CityBrisbane
Period2/08/185/08/18

Keywords

  • electrophysiology
  • Heart
  • pace mapping

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    Dharmaprani, D., Ganesan, A., & McGavigan, A. (2018). What is the Spatial Accuracy of the CARTO PaSo Module? An Independent Computational Geometric Analysis. S203. Abstract from 66th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, the International Society for Heart Research Australasian Section Annual Scientific Meeting and the 12th Annual Australia and New Zealand Endovascular Therapies Meeting, Brisbane, Australia. https://doi.org/10.1016/j.hlc.2018.06.363