54th Annual Meeting of the Association for European Paediatric and Congenital Cardiology (AEPC) Digital, Gothenburg, Sweden | 25–27 May 2021
Bibliographic record
Abstract
Introduction: CartoSound(EAM-ICE) intra-cardiac echocardiography(ICE) integrated with electro-anatomic mapping(EAM) is a new tool that has emerged in the field of pediatric electrophysiology. The combination of both technologies allows defining the arrhythmia propagation maps for different arrhythmia substrates while shows direct visualisation of cardiac structures and electrode tip. This report aims to describe our initial experience with CartoSound for cardiac ablations in paediatric patients, with and without congenital heart defects(CHD). Methods: The clinical and electrophysiologic data of the first 30 paediatric patients (<18 y old) in whom we used CartoSound@ (EAM-ICE) system for cardiac ablation was reviewed. The procedure was done using ALARA Fluro-protocol. A 3-dimensional shape of the heart was created using 8Fr SoundStar Probe. The ICE catheter was introduced via femoral vein access in 28 patients. In 2 cases, the ICE catheter was placed in the oesophagus. Results: The median age was 13,4 y (5-17,4) with 16 females. Arrhythmia substrates comprised 20 patients with WPW syndrome, 4 AVNRT, 3 VT and 3 focal atrial tachycardia. Twenty-one patients had a structurally normal heart, and 9 had CHD. Procedure duration was 200100 min(median SD), and fluoroscopy time was 10 3 min. 3D Cardiac anatomy acquisition took 45 30 min. ICE image quality was excellent in all cases. In all 7 patients with left-sided substrates, the transseptal puncture was guided by ICE with minimal fluoroscopy without tracheal intubation. Cryoablation was used in 2 patients, one with a parahisian pathway and another one with AVNRT in a fenestrated TCPC. The other 28 cases, radiofrequency was used. Non irrigated tip catheters were used in 26, and only two irrigated tip catheters were used for 2 pathways inside the coronary sinus. All applications were performed with direct visualisation of the ablation catheter tip in contact with the endocardium. Correlation between ablation efficacy and the cardiac contact with catheter tip was excellent. Acute success during ablation was achieved in 27/30 patients. No complications were reported. Conclusions: CartoSound(EAM-ICE) is an excellent tool for guiding cardiac catheter ablation in children. The demonstration of catheter position and direct visualisation of catheter tip contact during ablation lesions correlates well with ablation success.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".