Researchers from the Centro de Investigación Biomédica en Red de Enfermedades Cardiovascular (CIBERCV) of the Joan Cinca de San Pablo group have recently described a new technique to identify areas of scarring in patients with myocardial infarction by means of endocardium mapping of tissue electrical impedance.
In a preclinical study carried out in a porcine model of chronic myocardial infarction, it is evident that this procedure can allow recognition of the scar of the infarction and, theoretically, is not influenced by changes in the cardiac activation sequence. “Accurate identification of scar areas is essential for electrical ablation of arrhythmias in patients with myocardial infarction to provide optimal results,”says Dr. Cinca.
Currently, the identification of scar areas is based on a voltage mapping, i. e., analyzing the voltage of local electrocardiograms, so CIBERCV researchers have opened a new way, according to the head of the group. “Our study shows the mapping of the electrical impedance brought advantages over voltage mapping and, therefore, the simultaneous use of both procedures will allow a better detection of fibrosis zones and, in short, better results in patients undergoing ablation of ventricular arrhythmias,”Cinca says.
A pioneering study
This CIBERCV study is the first of its kind to analyze the ability to recognize areas of heart attack scar using a novel viewpoint based on the measurement of the electrical impedance catheter, a heart property that is influenced by the intrinsic structural characteristics of tissue. Previous investigations showed that this impedance is less in the scar of the infarction than in the normal myocardium, and this circumstance allows the recognition of the necrotic region.
Endocardial infarct scar recognition by myocardial electrical impedance is not influenced by changes in cardiac activation sequence. Amorós-Figueras G, Jorge E, Alonso-Martin C, Traver D, Ballesta M, Bragós R, Rosell-Ferrer J, Cinca J. Heart Rhythm. DOI: https://doi.org/10.1016/j.hrthm.2017.11.031