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Type: Journal article
Title: Clinical Validation and Comparison of Alternative Methods for Evaluation of Entrainment Mapping
Author: Derejko, P.
Szumowski, L.
Sanders, P.
Dimitri, H.
Kuklik, P.
Przybylski, A.
Urbanek, P.
Szufladowicz, E.
Bodalski, R.
Sacher, F.
Haissaguerre, M.
Walczak, F.
Citation: Journal of Cardiovascular Electrophysiology, 2009; 20(7):741-748
Publisher: Futura Publ Co
Issue Date: 2009
ISSN: 1045-3873
Statement of
Pawel Derejko, Lukasz J. Szumowski, Prashanthan Sanders, Hany Dimitri, Pawel Kuklik, Andrzej Przybylski, Piotr Urbanek, Ewa Szufladowicz, Robert Bodalski, Frederic Sacher, Michel Haissaguerre and Franciszek Walczak
Abstract: <h4>Introduction</h4>Measuring the postpacing interval (PPI) and correcting for the tachycardia cycle length (TCL) is an important entrainment response (ER). However, it may be impossible to measure PPI due to electrical noise on the mapping catheter. To overcome this problem, 2 alternative methods for the assessment of ER have been proposed: N+1 difference (N+1 DIFF) and PPIR method. PPI-TCL difference (PPI-TCL) correlates very well with ER assessed by new methods, but the agreement with PPI-TCL was established only in relation to PPIR method. Moreover, it is not known which of these methods is superior in the assessment of ER.<h4>Methods</h4>We analyzed 155 episodes of ER in 21 patients with heterogeneous reentrant arrhythmias. ER was estimated by PPI-TCL and by both alternative methods. Agreement between methods was assessed by means of the Bland-Altman test, kappa coefficient (kappa), and correlation coefficient (r). Finally, a mathematical comparison of the alternative methods was performed.<h4>Results</h4>The agreement between PPI-TCL and alternative methods was very good. For N+1 DIFF the mean difference was -1.86 +/- 7.31 ms; kappa = 0.9; r = 0.98; for PPIR method the mean difference was -1.46 +/- 7.65 ms; kappa = 0.92; r = 0.99. Agreement between both alternative methods was also very high: the mean difference of 0.5 +/- 6.6 ms; kappa = 0.89; r = 0.99. The analysis of the equations used for calculation of ER by these methods revealed that essentially they were mathematically equivalent.<h4>Conclusion</h4>Each of the alternative methods may be used for evaluation of ER when PPI-TCL cannot be assessed directly. Results obtained by both alternative methods are comparable.
Keywords: Humans
Electrophysiologic Techniques, Cardiac
Treatment Outcome
Cardiac Pacing, Artificial
Reproducibility of Results
Predictive Value of Tests
Models, Cardiovascular
Time Factors
Middle Aged
Tachycardia, Reciprocating
Description: The definitive version may be found at
DOI: 10.1111/j.1540-8167.2008.01425.x
Appears in Collections:Aurora harvest 5
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