<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT02216760</url>
  </required_header>
  <id_info>
    <org_study_id>14HH1922</org_study_id>
    <nct_id>NCT02216760</nct_id>
  </id_info>
  <brief_title>Using Ripple Mapping to Guide Substrate Ablation of Scar Related Ventricular Tachycardia.</brief_title>
  <acronym>Ripple-VT</acronym>
  <official_title>Determining the Pathophysiological Role of Slow Conduction Channels Identified by Ripple Mapping of the Ventricular Scar.</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Imperial College London</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Imperial College London</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      The heart beat is controlled by electrical signals. Following a heart attack, part of the&#xD;
      heart muscle dies and is later replaced by scar tissue. Within this area of scar, there often&#xD;
      remain &quot;channels&quot; of surviving tissue still able to transmit electrical signals. However, it&#xD;
      is well established that these &quot;conduction channels&quot; (CC) can form a short circuit around the&#xD;
      scar, leading to electrical disturbances (arrhythmias) that are potentially life threatening.&#xD;
      The commonest of these is ventricular tachycardia (VT), and is estimated to cause 300,000&#xD;
      deaths per year.&#xD;
&#xD;
      One recognised treatment option of VT involves burning (ablation) these &quot;conduction channels&quot;&#xD;
      (CC) within the scar. However, at present, the procedure is long and is far off 100%&#xD;
      effective. Consequently, current best practice does not rely on treating the VT, but rather&#xD;
      preventing it from causing sudden death - this is achieved with an Implantable Cardioverter&#xD;
      Defibrillator (ICD), a device which can recognise when a patient is in VT and deliver an&#xD;
      internal shock to restore the normal electrical conduction. Patients with defibrillators&#xD;
      subsequently are subject to recurrent painful and debilitating shocks which, although&#xD;
      lifesaving, significantly reduce their quality of life. The limitation with ablation at&#xD;
      present is due to the difficulty in visualising these CC's.&#xD;
&#xD;
      Investigators at Imperial College have created a novel electrogram visualisation program,&#xD;
      Ripple Mapping (RM), which they have already found to be superior to currently used&#xD;
      programmes in cases of arrhythmias in the upper chambers of the heart (the atria). During a&#xD;
      retrospective study in patients with scar related VT following a heart attack, when ablation&#xD;
      was delivered in areas associated with identified Ripple Mapping Conduction Channels, these&#xD;
      patients remained free of VT recurrence for &gt;2 year follow up interval.&#xD;
&#xD;
      The study hypothesis is that Ripple Mapping can identify all conduction channels within scar&#xD;
      tissue critical to the VT circuit, ablation of which will lead to long-term freedom from VT&#xD;
      and ICD therapies. The investigators now aim to perform a prospective randomised study&#xD;
      comparing Ripple Mapping guided VT ablation against conventional VT ablation.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      In patients with a previous heart attack, the scar formed in the left ventricle (bottom&#xD;
      chamber of the heart) consists of dead tissue mixed with strands of live tissue which form&#xD;
      &quot;conduction channels&quot; (CC's). These Conduction channels can cause dangerous heart rhythms&#xD;
      such as Ventricular Tachycardia (VT). This can lead to symptoms such as shortness of breath,&#xD;
      dizziness, blackouts, and, in some, sudden death.&#xD;
&#xD;
      Patients at risk of sudden death receive special implanted devices called implantable&#xD;
      cardioverter defibrillators (ICD) and can present with recurrent painful and debilitating ICD&#xD;
      therapies consisting of internal shocks. Patients experiencing frequent ICD shocks due&#xD;
      recurrent VT usually undergo a procedure to burn (ablate) the area of scar within the heart&#xD;
      thought to be the source of the VT. This involves catheters (plastic tubes) inserted into the&#xD;
      heart via the groin vessels allowing the cardiac electrophysiologists to obtain information&#xD;
      about the scar. Scar tissue has low electrical voltage. By measuring the electrical voltage&#xD;
      of the tissue in the heart, areas of scar as well as areas of live, healthy tissue can be&#xD;
      identified and mapped. By burning (ablation) these abnormal channels of live tissue within&#xD;
      scar (conduction channels), this can effectively reduce the episodes of VT a patient&#xD;
      experiences, thereby reducing the frequency of shocks they experience and improve their&#xD;
      quality of life.&#xD;
&#xD;
      In any one patient, more than 1 conduction channel and hence source of VT can be found.&#xD;
      Current mapping technologies are incapable of providing electrophysiologists with the&#xD;
      information that is required to locate all these conduction channels. Therefore ablation&#xD;
      strategies have shifted from ablating in a single location in the scar, to extensive ablation&#xD;
      within the scar in the hope that ALL conduction channels will be burnt. However, this&#xD;
      extensive ablation strategy has no globally agreed consensus with several techniques used&#xD;
      worldwide.&#xD;
&#xD;
      The disadvantage of this extensive ablation strategy is that the potential regions which can&#xD;
      be responsible for VT can be large, requiring extensive ablation and therefore prolonged&#xD;
      procedure times in sick patients who are unable to tolerate such lengthy procedures. In its&#xD;
      current state, VT ablation by any strategy is technically challenging and time consuming with&#xD;
      procedural times as long as 8 hours. In addition, although acute procedural success ranges&#xD;
      from 77% to 95%, recurrence rates remain high - up to 50%.&#xD;
&#xD;
      Therefore, identification of ALL conduction channels within scar is a desirable goal for&#xD;
      catheter ablation therapy in VT. Ripple Mapping (RM) is a novel mapping program which allows&#xD;
      simultaneous display of &quot;voltage&quot; and &quot;activation&quot; data of the underlying ventricular tissue.&#xD;
      RM therefore has the potential to display more detailed information of the functional&#xD;
      properties of the underlying scar including any interspersed live tissue channels.&#xD;
      Investigators at Imperial College have demonstrated the proof of concept of RM and validated&#xD;
      the program in a series of abnormal heart rhythms that arise within the upper heart chambers&#xD;
      (the atria) where RM was found to have a superior diagnostic yield as well as aiding the&#xD;
      operator in reaching a diagnosis in shorter time when compared with conventional mapping&#xD;
      systems. The Investigators subsequently performed a retrospective analysis of 21 patients&#xD;
      undergoing post infarct VT ablation. All documented locations with concealed entrainment or&#xD;
      perfect pace matches to the induced or clinical VT coincided with Ripple Mapping Conduction&#xD;
      Channels (RMCC). In patients where ablation lesions overlapped all identified RMCCs, these&#xD;
      patients remained free of VT recurrence for &gt;2 year follow up interval.&#xD;
&#xD;
      The Investigators therefore propose to study the hypothesis that Ripple Mapping can identify&#xD;
      all conduction channels within scar tissue critical to the VT circuit, ablation of which will&#xD;
      lead to long-term freedom from VT and ICD therapies. This will be determined via a&#xD;
      prospective randomised study comparing Ripple Mapping guided VT ablation against conventional&#xD;
      VT ablation.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Withdrawn</overall_status>
  <why_stopped>
    Terminated prior to randomised phase&#xD;
  </why_stopped>
  <start_date>August 2014</start_date>
  <completion_date type="Anticipated">August 2018</completion_date>
  <primary_completion_date type="Anticipated">August 2018</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Single (Participant)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Time to first appropriate ICD therapy</measure>
    <time_frame>24 months post ablation procedure</time_frame>
    <description>There will be a 1 week post procedural blanking period. Patients will be followed up at month 3, 6, 12, 18, 24 months for ICD device interrogation post blanking interval. The presence of appropriate ICD therapy as seen on the device download will be analysed on each occasion, and the time (days) from enrollment to the study to the ICD episode will be recorded.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Total appropriate ICD episodes</measure>
    <time_frame>24 months post ablation procedure</time_frame>
    <description>There will be a 1 week post procedural blanking period. Patients will be followed up at month 3, 6, 12, 18, 24 months for ICD device interrogation post blanking interval. Appropriate ICD therapy burden (Anti-tachycardia Pacing + shocks) as well VT below the therapy zone will be recorded since the last device download and reset. The total number of episodes will be calculated and recorded for each patient at the end of 2 year follow up interval.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>VT induction post procedure</measure>
    <time_frame>1 day</time_frame>
    <description>Immediately following VT ablation, programmed ventricular stimulation will be repeated to assess whether VT is inducible. Patient outcomes will be divided into 3 groups. Group A: VT non-inducible; Group B: Non-clinical VT induced. Group C: No RMCC's identified to guide ablation OR clinical VT remains inducible. The total number of patients in each group will be calculated and reported.</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">0</enrollment>
  <condition>Monomorphic Ventricular Tachycardia</condition>
  <condition>Myocardial Infarction</condition>
  <condition>Dilated Cardiomyopathy</condition>
  <arm_group>
    <arm_group_label>Ripple Mapping guided VT ablation</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Ripple Mapping (Imperial College) software (Biosense Webster) will be used to identify conduction channels within the ventricular scar substrate to guide ablation lesions in patients with monomorphic VT.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Conventional VT Ablation</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Standard substrate ablation as per local operator preference will be used to guide ablation in the ventricular scar in patients with monomorphic VT.</description>
  </arm_group>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Ripple Mapping guided VT ablation</intervention_name>
    <description>RM will be used to guide identification of conduction channels and hence substrate guided ablation</description>
    <arm_group_label>Ripple Mapping guided VT ablation</arm_group_label>
    <other_name>Ripple Mapping Carto 3 V4.2 System</other_name>
  </intervention>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Conventional VT ablation</intervention_name>
    <description>Substrate guided ablation using conventional methods (pace-mapping, LAVA/late potential abolition, scar border zone ablation)</description>
    <arm_group_label>Conventional VT Ablation</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          1. Evidence of VT (shock/ anti tachycardia pacing/ detection) on ICD (single, dual or&#xD;
             bi-ventricular) interrogation or 12 lead ECG.&#xD;
&#xD;
          2. Presumed scar related VT post myocardial infraction infarct/ dilated cardiomyopathy.&#xD;
&#xD;
          3. Age range 18-85yrs.&#xD;
&#xD;
          4. ICD implantation for primary or secondary prophylaxis, or device implantation&#xD;
             pre-discharge from hospital post ablation procedure.&#xD;
&#xD;
          5. Signed informed consent&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          1. Contraindication to catheter ablation&#xD;
&#xD;
          2. Coronary revascularisation required&#xD;
&#xD;
          3. Ventricular tachycardia due to transient, reversible causes&#xD;
&#xD;
          4. Presence of cardiac thrombus&#xD;
&#xD;
          5. Severe cerebrovascular disease&#xD;
&#xD;
          6. Active gastrointestinal disease&#xD;
&#xD;
          7. Renal failure with creatinine &gt;200 μmol/L or on dialysis&#xD;
&#xD;
          8. Active fever or infection&#xD;
&#xD;
          9. Life expectancy shorter than the trial&#xD;
&#xD;
         10. Allergy to contrast&#xD;
&#xD;
         11. Intractable heart failure (NYHA Class IV)&#xD;
&#xD;
         12. Bleeding or clotting disorders or inability to receive heparin&#xD;
&#xD;
         13. Pregnancy&#xD;
&#xD;
         14. Must not have previous (4 weeks prior to screening) or current participation in&#xD;
             another clinical trial with an investigational drug or investigational device&#xD;
&#xD;
         15. Unable to give informed consent&#xD;
&#xD;
         16. Unable to attend follow-up visits or ICD clinics&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>85 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Prapa Kanagaratnam, MBBChir PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Imperial College Healthcare NHS Trust</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Hammersmith Hospital, Imperial College Healthcare NHS Trust</name>
      <address>
        <city>London</city>
        <zip>W12 0HS</zip>
        <country>United Kingdom</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>United Kingdom</country>
  </location_countries>
  <reference>
    <citation>Linton NW, Koa-Wing M, Francis DP, Kojodjojo P, Lim PB, Salukhe TV, Whinnett Z, Davies DW, Peters NS, O'Neill MD, Kanagaratnam P. Cardiac ripple mapping: a novel three-dimensional visualization method for use with electroanatomic mapping of cardiac arrhythmias. Heart Rhythm. 2009 Dec;6(12):1754-62. doi: 10.1016/j.hrthm.2009.08.038. Epub 2009 Sep 3.</citation>
    <PMID>19959125</PMID>
  </reference>
  <reference>
    <citation>Jamil-Copley S, Linton N, Koa-Wing M, Kojodjojo P, Lim PB, Malcolme-Lawes L, Whinnett Z, Wright I, Davies W, Peters N, Francis DP, Kanagaratnam P. Application of ripple mapping with an electroanatomic mapping system for diagnosis of atrial tachycardias. J Cardiovasc Electrophysiol. 2013 Dec;24(12):1361-9. doi: 10.1111/jce.12259. Epub 2013 Oct 10.</citation>
    <PMID>24118203</PMID>
  </reference>
  <verification_date>May 2019</verification_date>
  <study_first_submitted>August 7, 2014</study_first_submitted>
  <study_first_submitted_qc>August 13, 2014</study_first_submitted_qc>
  <study_first_posted type="Estimate">August 15, 2014</study_first_posted>
  <last_update_submitted>May 14, 2019</last_update_submitted>
  <last_update_submitted_qc>May 14, 2019</last_update_submitted_qc>
  <last_update_posted type="Actual">May 16, 2019</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Monomorphic Ventricular Tachycardia</keyword>
  <keyword>Myocardial infarction</keyword>
  <keyword>Dilated cardiomyopathy</keyword>
  <keyword>Catheter ablation</keyword>
  <keyword>Substrate mapping</keyword>
  <keyword>Ripple Conduction channels</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Myocardial Infarction</mesh_term>
    <mesh_term>Cardiomyopathies</mesh_term>
    <mesh_term>Tachycardia</mesh_term>
    <mesh_term>Tachycardia, Ventricular</mesh_term>
    <mesh_term>Cardiomyopathy, Dilated</mesh_term>
    <mesh_term>Infarction</mesh_term>
  </condition_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT02216760
org study id: 14HH1922
nct id: NCT02216760
lead sponsor: 
has dmc: Yes
The heart beat is controlled by electrical signals. Following a heart attack, part of the
      heart muscle dies and is later replaced by scar tissue. Within this area of scar, there often
      remain "channels" of surviving tissue still able to transmit electrical signals. However, it
      is well established that these "conduction channels" (CC) can form a short circuit around the
      scar, leading to electrical disturbances (arrhythmias) that are potentially life threatening.
      The commonest of these is ventricular tachycardia (VT), and is estimated to cause 300,000
      deaths per year.

      One recognised treatment option of VT involves burning (ablation) these "conduction channels"
      (CC) within the scar. However, at present, the procedure is long and is far off 100%
      effective. Consequently, current best practice does not rely on treating the VT, but rather
      preventing it from causing sudden death - this is achieved with an Implantable Cardioverter
      Defibrillator (ICD), a device which can recognise when a patient is in VT and deliver an
      internal shock to restore the normal electrical conduction. Patients with defibrillators
      subsequently are subject to recurrent painful and debilitating shocks which, although
      lifesaving, significantly reduce their quality of life. The limitation with ablation at
      present is due to the difficulty in visualising these CC's.

      Investigators at Imperial College have created a novel electrogram visualisation program,
      Ripple Mapping (RM), which they have already found to be superior to currently used
      programmes in cases of arrhythmias in the upper chambers of the heart (the atria). During a
      retrospective study in patients with scar related VT following a heart attack, when ablation
      was delivered in areas associated with identified Ripple Mapping Conduction Channels, these
      patients remained free of VT recurrence for >2 year follow up interval.

      The study hypothesis is that Ripple Mapping can identify all conduction channels within scar
      tissue critical to the VT circuit, ablation of which will lead to long-term freedom from VT
      and ICD therapies. The investigators now aim to perform a prospective randomised study
      comparing Ripple Mapping guided VT ablation against conventional VT ablation.
In patients with a previous heart attack, the scar formed in the left ventricle (bottom
      chamber of the heart) consists of dead tissue mixed with strands of live tissue which form
      "conduction channels" (CC's). These Conduction channels can cause dangerous heart rhythms
      such as Ventricular Tachycardia (VT). This can lead to symptoms such as shortness of breath,
      dizziness, blackouts, and, in some, sudden death.

      Patients at risk of sudden death receive special implanted devices called implantable
      cardioverter defibrillators (ICD) and can present with recurrent painful and debilitating ICD
      therapies consisting of internal shocks. Patients experiencing frequent ICD shocks due
      recurrent VT usually undergo a procedure to burn (ablate) the area of scar within the heart
      thought to be the source of the VT. This involves catheters (plastic tubes) inserted into the
      heart via the groin vessels allowing the cardiac electrophysiologists to obtain information
      about the scar. Scar tissue has low electrical voltage. By measuring the electrical voltage
      of the tissue in the heart, areas of scar as well as areas of live, healthy tissue can be
      identified and mapped. By burning (ablation) these abnormal channels of live tissue within
      scar (conduction channels), this can effectively reduce the episodes of VT a patient
      experiences, thereby reducing the frequency of shocks they experience and improve their
      quality of life.

      In any one patient, more than 1 conduction channel and hence source of VT can be found.
      Current mapping technologies are incapable of providing electrophysiologists with the
      information that is required to locate all these conduction channels. Therefore ablation
      strategies have shifted from ablating in a single location in the scar, to extensive ablation
      within the scar in the hope that ALL conduction channels will be burnt. However, this
      extensive ablation strategy has no globally agreed consensus with several techniques used
      worldwide.

      The disadvantage of this extensive ablation strategy is that the potential regions which can
      be responsible for VT can be large, requiring extensive ablation and therefore prolonged
      procedure times in sick patients who are unable to tolerate such lengthy procedures. In its
      current state, VT ablation by any strategy is technically challenging and time consuming with
      procedural times as long as 8 hours. In addition, although acute procedural success ranges
      from 77% to 95%, recurrence rates remain high - up to 50%.

      Therefore, identification of ALL conduction channels within scar is a desirable goal for
      catheter ablation therapy in VT. Ripple Mapping (RM) is a novel mapping program which allows
      simultaneous display of "voltage" and "activation" data of the underlying ventricular tissue.
      RM therefore has the potential to display more detailed information of the functional
      properties of the underlying scar including any interspersed live tissue channels.
      Investigators at Imperial College have demonstrated the proof of concept of RM and validated
      the program in a series of abnormal heart rhythms that arise within the upper heart chambers
      (the atria) where RM was found to have a superior diagnostic yield as well as aiding the
      operator in reaching a diagnosis in shorter time when compared with conventional mapping
      systems. The Investigators subsequently performed a retrospective analysis of 21 patients
      undergoing post infarct VT ablation. All documented locations with concealed entrainment or
      perfect pace matches to the induced or clinical VT coincided with Ripple Mapping Conduction
      Channels (RMCC). In patients where ablation lesions overlapped all identified RMCCs, these
      patients remained free of VT recurrence for >2 year follow up interval.

      The Investigators therefore propose to study the hypothesis that Ripple Mapping can identify
      all conduction channels within scar tissue critical to the VT circuit, ablation of which will
      lead to long-term freedom from VT and ICD therapies. This will be determined via a
      prospective randomised study comparing Ripple Mapping guided VT ablation against conventional
      VT ablation.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: Single (Participant)
measure: Time to first appropriate ICD therapy
time frame: 24 months post ablation procedure
description: There will be a 1 week post procedural blanking period. Patients will be followed up at month 3, 6, 12, 18, 24 months for ICD device interrogation post blanking interval. The presence of appropriate ICD therapy as seen on the device download will be analysed on each occasion, and the time (days) from enrollment to the study to the ICD episode will be recorded.
measure: Total appropriate ICD episodes
time frame: 24 months post ablation procedure
description: There will be a 1 week post procedural blanking period. Patients will be followed up at month 3, 6, 12, 18, 24 months for ICD device interrogation post blanking interval. Appropriate ICD therapy burden (Anti-tachycardia Pacing + shocks) as well VT below the therapy zone will be recorded since the last device download and reset. The total number of episodes will be calculated and recorded for each patient at the end of 2 year follow up interval.
measure: VT induction post procedure
time frame: 1 day
description: Immediately following VT ablation, programmed ventricular stimulation will be repeated to assess whether VT is inducible. Patient outcomes will be divided into 3 groups. Group A: VT non-inducible; Group B: Non-clinical VT induced. Group C: No RMCC's identified to guide ablation OR clinical VT remains inducible. The total number of patients in each group will be calculated and reported.
arm group label: Ripple Mapping guided VT ablation
arm group type: Active Comparator
description: Ripple Mapping (Imperial College) software (Biosense Webster) will be used to identify conduction channels within the ventricular scar substrate to guide ablation lesions in patients with monomorphic VT.
arm group label: Conventional VT Ablation
arm group type: Active Comparator
description: Standard substrate ablation as per local operator preference will be used to guide ablation in the ventricular scar in patients with monomorphic VT.
intervention type: Device
intervention name: Ripple Mapping guided VT ablation
description: RM will be used to guide identification of conduction channels and hence substrate guided ablation
arm group label: Ripple Mapping guided VT ablation
other name: Ripple Mapping Carto 3 V4.2 System
intervention type: Device
intervention name: Conventional VT ablation
description: Substrate guided ablation using conventional methods (pace-mapping, LAVA/late potential abolition, scar border zone ablation)
arm group label: Conventional VT Ablation
criteria: 
gender: All
minimum age: 18 Years
maximum age: 85 Years
healthy volunteers: No
last name: Prapa Kanagaratnam, MBBChir PhD
role: Principal Investigator
affiliation: Imperial College Healthcare NHS Trust
facility: 
country: United Kingdom
citation: Linton NW, Koa-Wing M, Francis DP, Kojodjojo P, Lim PB, Salukhe TV, Whinnett Z, Davies DW, Peters NS, O'Neill MD, Kanagaratnam P. Cardiac ripple mapping: a novel three-dimensional visualization method for use with electroanatomic mapping of cardiac arrhythmias. Heart Rhythm. 2009 Dec;6(12):1754-62. doi: 10.1016/j.hrthm.2009.08.038. Epub 2009 Sep 3.
PMID: 19959125
citation: Jamil-Copley S, Linton N, Koa-Wing M, Kojodjojo P, Lim PB, Malcolme-Lawes L, Whinnett Z, Wright I, Davies W, Peters N, Francis DP, Kanagaratnam P. Application of ripple mapping with an electroanatomic mapping system for diagnosis of atrial tachycardias. J Cardiovasc Electrophysiol. 2013 Dec;24(12):1361-9. doi: 10.1111/jce.12259. Epub 2013 Oct 10.
PMID: 24118203
responsible party type: Sponsor
mesh term: Myocardial Infarction
mesh term: Cardiomyopathies
mesh term: Tachycardia
mesh term: Tachycardia, Ventricular
mesh term: Cardiomyopathy, Dilated
mesh term: Infarction