Cardiovascular Ultrasound Scientific and Case Reports Session
Non-invasive 3D Electromechanical Cycle Length Mapping for Atrial Fibrillation Mapping and Ablation Response Prediction
Tuesday, April 9, 2024
2:02pm – 2:09pm
Location: 410
Authors: Melina Tourni, Columbia University Seungyeon Julia Han, Columbia University Mary Kucinski, Columbia University Angelo Biviano, NewYork-Presbyterian, Columbia Elisa Konofagou, Columbia ,
This presentation aspires to offer profound insights into using echocardiography for arrhythmia characterization and treatment efficacy evaluation. We focus on Atrial Fibrillation (AF), for which current treatment modalities, primarily catheter ablation, demonstrate an initial success rate of 50-70%, necessitating recurrent interventions. This study introduces a pioneering, ultrasound-based approach, Electromechanical Cycle Length Mapping (ECLM), that non-invasively maps the cardiac electromechanical activation rates in 2D and pseudo-3D transmurally.
In this study, subjects were imaged before and after their clinically successful AF ablation. Metrics quantifying the percentage of ECLM arrhythmia triggers emerging and Cycle Length Dispersion (CLD) localized across the myocardium are markers for detecting arrhythmia presence and defining ablation success. Pre-ablation ECLM results underscore the presence of arrhythmic activation patterns, elucidating regions of concern. Following ablation, ECLM unequivocally verifies immediate success across all subjects, manifesting a significant reduction in irregularities.
The primary revelation is the emergence of pre-ablation CLD as an autonomous predictor of 3-month long-term ablation efficacy. Residual triggers in the post-ablation maps may indicate incompletely addressed areas and prospects for further ablation. This presentation will introduce a state-of-the-art tool that may revolutionize personalized arrhythmia treatment planning and early detection, redefining current clinical approaches and introducing new, innovative echocardiography uses.