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1 Cardiovascular System Laboratory, Bruce Rappaport Faculty of Medicine, and 2 Department of Cardiothoracic Surgery, Carmel Medical Center, Technion-Israel Institute of Technology, Haifa 31096; and 3 Department of Zoology, Tel-Aviv University, Tel-Aviv, Israel 69978
Precise identification of
infarcted myocardial tissue is of importance in diagnostic and
interventional cardiology. A three-dimensional, catheter-based
endocardial electromechanical mapping technique was used to assess the
ability of local endocardial impedance in delineating the exact
location, size, and border of canine myocardial infarction.
Electromechanical mapping of the left ventricle was performed in a
control group (n = 10) and 4 wk after left anterior
descending coronary artery ligation (n = 10).
Impedance, bipolar electrogram amplitude, and endocardial local
shortening (LS) were quantified. The infarcted area was compared
with the corresponding regions in controls, revealing a significant
reduction in impedance values [infarcted vs. controls: 168.8 ± 11.7 and 240.7 ± 22.3
, respectively (means ± SE),
P < 0.05] bipolar electrogram amplitude (1.8 ± 0.2 mV, 4.4 ± 0.7 mV, P < 0.05), and LS (
2.36 ± 1.6%, 11.9 ± 0.9%, P < 0.05). The accuracy of the impedance maps in
delineating the location and extent of the infarcted region was
demonstrated by the high correlation with the infarct area (Pearson's
correlation coefficient = 0.942) and the accurate identification of the infarct borders in pathology. By accurately defining myocardial infarction and its borders, endocardial impedance mapping may become a
clinically useful tool in differentiating healthy from necrotic
myocardial tissue.
myocardial viability assessment; electromechanical coupling; electrophysiology
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