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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Premature ventricular contraction activation map&#44; projected in an upper anterior view&#44; with the earliest activation point located in the left coronary cusp&#46; Both maps were performed in 12 minutes&#46; A&#46; This high-density activation map was produced with the PMF and the PentaRay catheter and included 547 points&#44; resulting in a very detailed and accurate map&#46; B&#46; Standard activation map performed without PMF&#46; Points were collected with the ablation catheter and required manual validation&#44; resulting in fewer points being collected in the same amount of time &#8211; 42 points&#46; Also&#44; the bipolar endocardial electrogram had a lower voltage amplitude signal with larger electrogram duration compared to the bipolar electrogram acquired with the PentaRay catheter&#46;</p>"
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More recently&#44; new software called Pattern Matching Filter &#40;PMF&#41; &#40;Biosense Webster&#41;&#44; which enables a correlation between the predefined template morphology and the real time beat to be made&#44; has been proposed to improve ablation outcomes&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Moreover&#44; multielectrode catheters with smaller electrodes and closer interelectrode spacing have already demonstrated their advantage when mapping atrial or ventricular scars&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The purpose of the current case series was to investigate the usefulness of the new software PMF in addition to the PentaRay multielectrode mapping catheter for complex PCV ablation&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study design and setting</span><p id="par0025" class="elsevierStylePara elsevierViewall">Prospective observational study of consecutive patients with frequent symptomatic PVCs referred for catheter ablation at our center from January to September 2018&#46; These patients underwent ablation using a pre-specified mapping strategy with the PMF software and the PentaRay catheter&#46; Procedural endpoints and acute and 12-month follow-up results were assessed and compared to a 12-month retrospective cohort of patients who underwent complex PVC ablation with standard activation mapping performed with the use of the Thermocool SmartTouch irrigated tip contact force-sensing ablation catheter &#40;ST - Biosense Webster&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">All patients provided written informed consent and the study was approved by the local institutional ethics committee&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Patient eligibility criteria</span><p id="par0035" class="elsevierStylePara elsevierViewall">Patients from both the study and control groups were eligible for inclusion in the study if they presented at least one criteria from group A plus at least one from group B&#46; Group A criteria included&#58; i&#41; symptomatic drug-refractory PVCs&#44; or ii&#41; a decline in left ventricular ejection fraction &#40;LVEF&#41; due to frequent PVCs&#46; Group B criteria included&#58; i&#41; a previous history of PVC ablation&#44; or ii&#41; a left-sided PVC&#46; All patients underwent evaluation for any underlying structural heart disease&#44; and major coronary artery disease had to be ruled out by cardiac angiography or stress testing in cases of LVEF dysfunction&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Exclusion criteria were as follows&#58; presence of structural heart disease &#40;ischemic heart disease&#44; significant valvular disease or genetic or infiltrative cardiomyopathy&#41;&#44; pregnancy and any clinical contraindication for the ablation procedure&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Ablation procedure</span><p id="par0045" class="elsevierStylePara elsevierViewall">All procedures in both the prospective and retrospective groups were performed by the same primary operator&#46; They were conducted under local anesthesia and all anti-arrhythmic drugs &#40;AAD&#41; stopped at least five half-lives before the procedure&#46; For left-sided procedures&#44; a retrograde approach was first choice&#44; but access via transseptal puncture was also obtained whenever necessary&#46; Intravenous heparin was administered to maintain an activated clotting time &#8805;300 seconds for left-sided procedures&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Anatomical mapping data was collected using a 3D mapping system &#40;CARTO3&#174;&#44; Biosense Webster&#41; and respiratory noise was excluded &#40;AccuResp Module&#44; Biosense Webster&#41;&#46; Activation mapping was performed using a high-density system &#40;Confidense&#174; Module&#44; Biosense Webster&#41; and signal annotation conducted using Wavefront activation software &#40;Biosense Webster&#41;&#44; which analyses and integrates bipolar signals and the corresponding negative onset of unipolar signal&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The use of intracardiac echocardiography was left to the physician&#39;s discretion&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Ablation was performed using a ST ablation catheter&#44; in power-controlled mode with temperature limited to 43<span class="elsevierStyleHsp" style=""></span>&#176;C and saline irrigation speed of 17 mL&#47;min&#46; The power setting was 20 W and could be titrated up to 40 W&#44; depending on the region being targeted&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">When the ectopic focus was located in the coronary cusps&#44; coronary angiography &#40;CA&#41; was routinely performed&#46; If the focus was at a safe distance &#40;&#62;6 mm&#41;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> from the coronary artery&#44; radiofrequency &#40;RF&#41; was delivered&#46; After ablation&#44; CA was performed again in order to exclude any damage to the coronary arteries&#46; When ablation was performed beneath the coronary cusps&#44; CA was not required given the probable distance from the coronary arteries&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">After ablation&#44; patients were monitored for at least 30 minutes in de novo cases and 60 minutes in redo procedures to avoid recurrence&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">All AAD were discontinued after successful procedures&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Systematic transthoracic echocardiography was performed before discharge to exclude aortic valve damage or pericardial effusion&#46; A 24-h Holter was also performed before discharge&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Pattern Matching Filter software</span><p id="par0085" class="elsevierStylePara elsevierViewall">This new software was released with version 6 of the CARTO3&#174; system&#46; It allows the acquisition of local activation time &#40;LAT&#41; points based on real time comparison of the 12-lead electrocardiogram &#40;ECG&#41; morphology with a morphology of interest &#40;template&#41;&#46; Essentially&#44; this software enables a correlation to be made between the predefined morphology and every real time beat&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Each activation point collected with the mapping catheter must follow some intrinsic steps before validation &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A-H&#41;&#58; &#40;A&#41; definition of the pattern &#8211; selection of the template morphology to be mapped and adjustment of the window of interest &#40;WOI&#41;&#59; &#40;B&#41; single channel correlation &#8211; the fit between the template and the current beat is calculated for each of the 12 leads using Pearson correlation formula&#59; calculation of overall weighted &#8211; &#40;C&#41; in this step the absolute voltage is measured for each lead &#40;for the template and for the beat&#41;&#59; &#40;D&#41; lead correlation &#8211; the total sum of each pair of leads &#40;template and beat&#41; is calculated and then &#40;E&#41; divided by the total sum of all leads weight&#59; &#40;F&#41; lead contribution &#8211; the lead correlation is multiplied by the weighted average and the result &#40;G&#41; is the final weighted average score&#59; &#40;H&#41; phase shift of &#177;40 ms &#8211; this step takes into consideration a possible offset between reference annotations in beats with similar morphology&#46; Finally&#44; the Pattern Matching percentage is compared to the threshold &#8211; if the matching percentage is equal to or higher than the threshold&#44; the beat is considered to represent the template morphology and is incorporated into the activation map&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Study group patients &#40;Pattern Matching Filter with PentaRay Catheter&#41;</span><p id="par0095" class="elsevierStylePara elsevierViewall">At the beginning of the procedure&#44; while monitoring the patient&#44; the culprit PVC was quickly acquired and defined as the template morphology to be mapped &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>I-L&#41;&#46; The morphology of the reference channel in sinus rhythm and in tachycardia should be similar to avoid missing beats&#46; The WOI was adjusted to include only the QRS complex&#46; Thereafter&#44; in the Pattern Matching box we selected the pattern to be mapped and a minimum of 95&#37; correlation&#46; We were then able visualize&#44; in continuous mapping&#44; the correlation of the selected template to the real time PVCs and adjust the WOI again&#44; if necessary&#46; Also&#44; we increased the threshold in all cases to at least 97&#37;&#46; After all these steps were performed&#44; we started our mapping process with the PentaRay catheter and visualized which beats passed or failed in the selected template morphology&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The ventricular geometry&#44; outflow tract or aortic cusps were collected with the PentaRay catheter and&#44; when available&#44; integrated with a CT reconstruction of the outflow tract &#40;CartoMerge&#44; Biosense Webster&#41;&#46; The PentaRay has 1-mm electrodes with interelectrode spacings of 2-6-2 mm&#44; in order to provide more detailed electrogram information&#46; To avoid using extrapolation from ECG Wilson&#39;s triangle and noise&#44; we placed a hexapolar catheter &#40;Biosense Webster&#41; on the right ventricle to obtain a clean unipolar signal since this catheter has a specific electrode placed in the inferior vena cava&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Our initial approach consisted of collecting only anatomical points with fast anatomical mapping &#40;FAM&#41;&#46; After defining the geometry&#44; we started collecting LAT points&#46; However&#44; if at the beginning of the procedure the patient presented only rare PVCs&#44; geometry and activation maps were performed simultaneously&#46; If very few or no PVCs were observed at baseline&#44; intravenous administration of isoproterenol or programmed ventricular stimulation was performed&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Only PVCs selected by the PMF &#8211; exceeding the minimum threshold &#40;position stability&#61;3 mm&#44; maximum density and tissue contact selected&#41; &#8211; were added to the LAT map and no LAT point was edited after automatic annotation&#46; Once the focus was well defined&#44; we shifted to an ST ablation catheter&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Control group patients &#40;local activation time with ablation catheter&#41;</span><p id="par0115" class="elsevierStylePara elsevierViewall">The approach was similar to the aforementioned&#44; but the whole anatomy was constructed with the Thermocool SmartTouch catheter&#44; which has a 3&#46;5-mm electrode tip with interelectrode spacings of 1-6-2 mm&#46; After defining the geometry with FAM&#44; we started collecting LAT points&#46; Points were also acquired automatically &#40;position stability&#61;3 mm&#44; maximum density and a minimum tissue contact of 3 g&#41;&#44; however each point required manual confirmation before validation and incorporation into the activation map&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Study endpoints</span><p id="par0120" class="elsevierStylePara elsevierViewall">The primary endpoint of this study was the utility of the combined use of PMF with PentaRay catheter during the procedure&#44; assessed by the number of activation points acquired&#44; total RF time to eliminate PVC and overall procedure time&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Secondary endpoints included acute and 12-month effectiveness and safety of the ablation procedure&#46; Acute success was defined as the complete abolition of the clinical ventricular arrhythmia at the end of a 30-minute waiting period &#40;or 60 minutes for re-dos&#41;&#46; Follow-up effectiveness was defined by a reduction in PVC burden of at least 80&#37;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">6</span></a> and safety endpoints included any major complications &#40;vascular injury requiring transfusion or vascular surgery&#44; cardiac tamponade&#44; stroke or other systemic emboli&#44; and damage to the aortic valve or coronary arteries&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Follow-up</span><p id="par0130" class="elsevierStylePara elsevierViewall">After the index procedure&#44; patients were routinely seen at three and 12-months&#46; Data collected during follow-up included a 12-lead ECG and a 24-h Holter at each visit&#46; In case of previous LV dysfunction&#44; assessment of LVEF by echocardiography was also performed to confirm an improvement in LVEF&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Results</span><p id="par0135" class="elsevierStylePara elsevierViewall">During the nine-month enrollment period&#44; a total of seven patients fulfilled our inclusion criteria and were treated with the combined use of the PMF software and the PentaRay catheter&#46; The control group included four patients who underwent conventional mapping&#46;</p><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Study group &#40;Pattern Matching Filter with PentaRay catheter&#41;</span><p id="par0140" class="elsevierStylePara elsevierViewall">The seven patients from the PMF group are described in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> &#8211; one was a 13-year old male undergoing a redo ablation for RVOT PVC&#44; while the other six patients had PVCs arising from the LV &#40;five from the LVOT and one from the anterolateral papillary muscle&#41;&#46; All seven patients had a high PVC burden &#40;&#62;32 000 PVC&#47;24 h&#41;&#44; with multiple and long episodes of bigeminy in all of them&#46; The mean LVEF was 47&#177;8&#37; and three patients had LVEF&#60;45&#37;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">The mean number of points acquired with the PentaRay catheter was 507&#177;213 before ablation during 15&#177;10 min of mapping&#46; In the first patient&#44; who was undergoing a redo ablation of a PVC arising near the His bundle&#44; mapping was carried out with the PentaRay in both the RVOT and the coronary cusps&#44; particularly the non-coronary cusp &#40;NCC&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>A&#41;&#46; However&#44; since the earliest activation site was located in the RVOT&#44; with an optimal unipolar signal&#44; ablation was performed there&#46; In the other patients&#44; the earliest LAT was located in the left coronary cusp &#40;LCC&#41; &#40;n&#61;3&#41; &#8211; one in the LCC &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>&#41; and two beneath &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>B&#41;&#44; the papillary muscle &#40;n&#61;1&#41;&#44; the aortic mitral continuity &#40;AMC&#41; &#40;n&#61;1&#41; and the right &#40;RCC&#41;-NCC commissure &#40;n&#61;1&#41;&#46; Median procedure and RF ablation times were 67&#177;42 min and 294&#177;112 s&#44; respectively&#46; Acute success was achieved in all patients &#40;100&#37;&#41;&#46; Coronary angiography was performed in three patients &#8211; two cases of LCC PVCs and one with PVCs arising from the RCC-NCC commissure&#46; In all patients&#44; the coronary arteries were at a safe distance from the ablation catheter&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall">At 12 months post-procedure&#44; there was no clinical recurrence&#44; with all patients presenting a reduction in PVC burden of at least 80&#37; compared with baseline&#44; despite being off AAD&#46; Of the three patients with LVEF&#60;45&#37;&#44; two had complete normalization of LVEF&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Control Group &#40;LAT with Ablation Catheter&#41;</span><p id="par0155" class="elsevierStylePara elsevierViewall">Only four patients matched the inclusion criteria &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41; and were included in our study &#8211; all of them had PVCs from the LV &#40;from the LCC&#44; the RCC&#44; the AMC &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>C&#41; and the posteromedial papillary muscle&#44; respectively&#41;&#46; Similar to patients from the PMF group&#44; all four control patients had a high PVC burden &#40;&#62;23 000 PVC&#47;24 h&#41;&#46; Two patients had LVEF&#60;45&#37;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0160" class="elsevierStylePara elsevierViewall">During 36&#177;24 min of mapping&#44; the mean number of points acquired with the ablation catheter was 90&#177;62&#46; Median procedure and RF ablation times were 130&#177;54 min and 706&#177;613 s&#44; respectively&#46; Acute success was achieved in three of the four patients&#46; The patient with PVCs arising from the RCC had a recurrence during the waiting period &#40;mapping in this patient was also performed in the RVOT&#44; but ablation was unsuccessful&#41;&#46; Coronary angiography was performed in two patients &#8211; with LCC and RCC PVCs&#44; respectively&#46; In both cases&#44; the coronary arteries were at a safe distance from the ablation catheter&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">At 12 months post-procedure&#44; the three patients who had had a successful ablation remained symptom free&#44; with a PVC burden reduction of &#62;80&#37;&#44; despite being off AAD&#46; The two patients with a LVEF&#60;45&#37; had full LVEF recovery&#46;</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Complications</span><p id="par0170" class="elsevierStylePara elsevierViewall">No acute complications were observed in any of the groups&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Discussion</span><p id="par0175" class="elsevierStylePara elsevierViewall">To our knowledge&#44; this is the first study assessing the use of the PMF software in combination with the PentaRay mapping catheter for complex PVC ablation&#46; This prospective study illustrates the advantages of combining a multipolar electrode mapping catheter with the PMF software for complex PVC ablation&#44; with four main benefits&#58; &#40;1&#41; a much more detailed and accurate activation map&#59; &#40;2&#41; a reliable map&#44; since only PVCs with &#8805;97&#37; correlation with the template morphology were collected and incorporated&#59; &#40;3&#41; a reduction in the RF delivery time and finally&#44; &#40;4&#41; a reduction in the procedure time&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">The PentaRay is a tissue contact high-density multipolar electrode mapping catheter&#44; capable of acquiring multiple LAT points &#40;up to 20 simultaneously&#41;&#46; It also covers a surface of more than 7 cm<span class="elsevierStyleSup">2</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a> By acquiring simultaneous LAT points&#44; it allows us to obtain a more detailed activation map and the mapping time is shorter&#46; In our study&#44; maps obtained in patients in the PMF group combined with the PentaRay catheter had a fivefold number of LAT points &#40;507&#177;213 vs&#46; 90&#177;62 points&#41; and took less than half the time &#40;15&#177;10 vs&#46; 36&#177;24 min&#41; compared with the control group&#46; Also&#44; unlike the ablation catheter &#40;3&#46;5 mm tip&#41;&#44; the PentaRay has 1 mm electrodes with closer interelectrode spacing&#44; which results in less signal averaging and fewer cancellation effects&#44; and higher bipolar voltage amplitude with shorter electrogram duration&#46; This subsequently allows more accurate time annotation&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a> Moreover&#44; the use of the PentaRay catheter can be particularly important in patients who present with few PVCs at the time of the procedure&#46; In our clinical practice this is one of the most common reasons for procedure abandonment and re-scheduling&#46; By allowing the simultaneous acquisition of multiple points&#44; the activation map can be performed with fewer PVCs&#46; Furthermore&#44; due to the increased electrical density&#44; the pace map will be more precise since ventricular capture can be achieved with a lower output&#44; unlike what is observed when using a standard ablation catheter&#44; particularly in the aortic root&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0185" class="elsevierStylePara elsevierViewall">As previously detailed&#44; the PMF software follows five intrinsic steps before validation of the point&#58; definition of the pattern&#44; single channel correlation&#44; calculation of overall weighted&#44; repetition of the overall weight with phase shift of &#177;40 ms and finally the best result is compared to the threshold&#46; In this study&#44; by setting a higher correlation threshold with the PVC morphology to be mapped&#44; only points with &#8805;97&#37; correlation were automatically added to the activation map&#46; This meant that each point of the activation map was highly reliable&#46; This higher correlation threshold together with how the Wavefront is analyzed &#40;bipolar and unipolar signals&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a> mitigates one of the potential disadvantages of the PentaRay&#44; the triggering of mechanical PVCs&#44; and also avoids the acquisition of PVCs arising from close locations&#44; which could decrease the accuracy of the map&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">In our study&#44; the multielectrode mapping catheter with the PMF software allowed a lower RF time &#40;294&#177;99 vs&#46; 706&#177;613 sec&#41; and also practically halved the procedure duration &#40;67&#177;42 vs&#46; 130&#177;54 min&#41;&#44; meaning there is potential for a higher patient turnover in the electrophysiology laboratory&#46; Importantly&#44; despite the reduction in the RF and procedure times&#44; the safety and effectiveness of the procedure were not affected&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Further studies may help clarify whether this strategy is associated with higher success rates than standard approaches&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Limitations</span><p id="par0200" class="elsevierStylePara elsevierViewall">We acknowledge several limitations of our work&#46; First&#44; this was a single-center study performed by the same primary operator in a relatively high volume tertiary center&#44; therefore our results may not be applicable to other centers&#46; Second&#44; few patients were included in both groups and therefore any comparison is inherently underpowered&#46; However&#44; our primary goal was to provide the first description of the combined use of the PentaRay catheter and the PMF software and illustrate its advantages&#46; Moreover&#44; our inclusion criteria were very restrictive&#44; particularly in the control group&#44; allowing only patients with complex PVCs who underwent ablation with the CARTO3 system with the same CF ablation catheter&#46; Third&#44; there is no uniformly accepted definition of successful ablation and so our results may differ from other studies using different definitions&#46; Fourth&#44; this approach cannot be performed in cases where the PVC arises from the distal coronary sinus&#46; Fortunately&#44; these cases are infrequent and even with the ablation catheter sometimes it is impossible to reach the target due to the coronary sinus anatomy&#46; Finally&#44; we acknowledge the cost of adding a multipolar mapping catheter on top of an ablation catheter with tridimensional mapping&#46; This is why we only included complex cases &#8211; re-dos or left PVC ablations&#44; which are normally associated with lower success rates&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> This does not preclude the use of this approach in patients with RVOT PVCs&#44; particularly in those with few PVCs&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conclusion</span><p id="par0205" class="elsevierStylePara elsevierViewall">In this first study assessing the combined use of the PentaRay mapping catheter and the Pattern Matching Filter software for the ablation of complex PVCs&#44; we demonstrate how this approach can improve the level of detail&#44; accuracy and reliability of the activation map&#44; while reducing the number of radiofrequency applications and procedural time&#46; Further studies may be required to assess whether this approach can lead to improved outcomes&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Conflicts of interest</span><p id="par0210" class="elsevierStylePara elsevierViewall">P&#46;A&#46;S has received speaker fees from Biosense Webster&#44; Boston Scientific and St&#46; Jude Abbott&#46; All other authors have reported that they have no relationships relevant to the contents of this paper to disclose&#46;</p></span></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Purpose</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Our goal was to assess usefulness of Pattern Matching Filter &#40;PMF&#41; software combined with the PentaRay catheter for complex premature ventricular contraction &#40;PVC&#41; ablation&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A prospective observational study of consecutive patients referred for complex PVC ablation at our tertiary center from January to September 2018&#46; Patients underwent ablation using a pre-specified mapping strategy with the PMF and the PentaRay catheter &#40;PVCs with &#8805;97&#37; correlation with the template morphology were collected&#41;&#46; Procedural endpoints and acute and 12-months success rates were assessed and compared to a retrospective cohort of patients who also underwent a complex PVC ablation with standard activation mapping performed with a Thermocool SmartTouch catheter&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">During the nine-month enrollment period&#44; seven patients fulfilled our inclusion criteria&#44; while there were four patients in the control group&#46; Patients treated with the PMF and PentaRay had a fivefold number of points acquired &#40;507&#177;213 vs&#46; 90&#177;62&#41; and a halved procedure time &#40;67&#177;42 vs&#46;130&#177;54 min&#41;&#44; required a shorter radiofrequency ablation time &#40;294&#177;112 vs&#46;706&#177;613 sec&#41; and had a higher overall success rate &#40;100&#37; vs&#46;75&#37;&#41; when compared to the standard approach&#46; No major complications occurred in either group&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In this first study assessing the combined use of the PentaRay catheter and the PMF for complex PVCs ablation&#44; we demonstrate how this approach can improve the level of detail&#44; accuracy and reliability of the activation map&#44; while reducing the number of radiofrequency applications and procedural time&#46; Further studies are warranted to confirm whether this approach can lead to improved outcomes&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Purpose"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Avaliar a utilidade da abordagem conjunta do <span class="elsevierStyleItalic">software</span><span class="elsevierStyleItalic">Pattern Matching Filter</span> &#40;PMF&#41; com o cateter <span class="elsevierStyleItalic">PentaRay</span> na abla&#231;&#227;o de extrass&#237;stole ventricular &#40;ESV&#41; complexa&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudo observacional prospetivo de doentes consecutivos referenciados para abla&#231;&#227;o de ESV complexa &#40;re-dos ou ESV esquerda&#41; de janeiro a setembro de 2018&#46; Os pacientes foram submetidos a uma estrat&#233;gia de mapeamento predefinida com o PMF e o cateter <span class="elsevierStyleItalic">PentaRay</span> &#40;ESV com &#8805;97&#37; de correla&#231;&#227;o com a morfologia definida&#41;&#46; Os objetivos prim&#225;rios&#44; bem como o sucesso agudo e a 12 meses&#44; foram avaliados e comparados com uma coorte retrospetiva de pacientes tamb&#233;m sujeitos a abla&#231;&#227;o de ESV complexa mas com um mapa de ativa&#231;&#227;o convencional realizado com o cateter de abla&#231;&#227;o <span class="elsevierStyleItalic">Thermocool SmartTouch</span>&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Durante os nove meses foram inclu&#237;dos sete pacientes que preencheram os crit&#233;rios e quatro foram no grupo controlo&#46; Os pacientes tratados com o PMF e o cateter <span class="elsevierStyleItalic">PentaRay</span> tiveram cinco vezes mais pontos adquiridos &#40;507&#177;213 <span class="elsevierStyleItalic">versus</span> 90&#177;62&#41; e metade do tempo de procedimento &#40;67&#177;42 <span class="elsevierStyleItalic">versus</span> 130&#177;54 min&#41;&#44; apresentaram menor tempo de abla&#231;&#227;o &#40;294&#177;112 <span class="elsevierStyleItalic">versus</span> 706&#177;613 sec&#41; e uma maior taxa de sucesso &#40;100&#37; <span class="elsevierStyleItalic">versus</span> 75&#37;&#41; quando comparados com a abordagem convencional&#46; N&#227;o se verificaram complica&#231;&#245;es em ambos os grupos&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Neste primeiro estudo a avaliar a abordagem conjunta do cateter <span class="elsevierStyleItalic">PentaRay</span> com o PMF para a abla&#231;&#227;o de ESV complexa&#44; demonstramos que esta abordagem melhora o detalhe&#44; a precis&#227;o e a fiabilidade do mapa de ativa&#231;&#227;o&#44; ao mesmo tempo que reduz o tempo de radiofrequ&#234;ncia e do procedimento&#46; Estudos adicionais ser&#227;o necess&#225;rios para confirmar se esta abordagem melhora o sucesso&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclus&#245;es"
          ]
        ]
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1412
            "Ancho" => 2508
            "Tamanyo" => 320533
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        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">&#40;A-H&#41; Pattern Matching Filter &#40;PMF&#41; algorithm workflow &#40;as described in technical presentation for health care professionals&#59; with permission from Biosense Webster&#41;&#46; &#40;I-L&#41; Utilization of the PMF software in a patient with premature ventricular contraction arising from the left coronary cusp&#46; I&#46; Selection of the premature ventricular contraction as the template morphology to be mapped&#46; J&#46; Window of interest &#40;WOI&#41; adjustment in order to include only the QRS complex&#46; K&#46; A 95&#37; minimum threshold was selected and during continuous mapping&#44; each premature ventricular contraction and its respective correlation were visualized&#46; L&#46; Since the vast majority of premature ventricular contraction presented a correlation of between 97 and 99&#37;&#44; WOI was adjusted and the minimum threshold was set at 97&#37;&#46; After all the steps were performed&#44; we started collecting geometry and activation points with the PentaRay catheter&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1958
            "Ancho" => 1740
            "Tamanyo" => 288198
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">A&#46; Premature ventricular contraction &#40;PVC&#41; activation map&#44; projected in a posterior view&#44; with the earliest activation point located in the right ventricular outflow tract &#40;RVOT&#41; slightly above the His bundle &#40;5 mm away&#41;&#46; This high-density activation mapping&#44; performed with the PMF and the PentaRay mapping catheter&#44; included 816 points &#40;379 in the RVOT&#41;&#44; resulting in a very detailed and accurate map&#46; B&#46; This high-density activation mapping included 308 points&#44; with the earliest activation point just beneath the left coronary cusp&#46; The figure is projected in the upper left posterior view&#46; Also&#44; in both maps performed with the PMF software and the PentaRay mapping catheter&#44; the bipolar endocardial electrograms were less fractionated and had a higher voltage amplitude signal compared to the bipolar electrogram acquired with the ablation catheter&#44; and so potentially more accurate&#46; C&#46; PVC activation map&#44; projected in upper posterior view&#44; with the earliest activation point in the aortomitral continuity&#46; This activation map was performed with the standard approach and ST ablation catheter&#46; Only 104 local activation time points were collected&#44; since each point needs manual confirmation before validation and incorporation into the activation map&#44; resulting in a less detailed map&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1762
            "Ancho" => 1740
            "Tamanyo" => 221375
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Premature ventricular contraction activation map&#44; projected in an upper anterior view&#44; with the earliest activation point located in the left coronary cusp&#46; Both maps were performed in 12 minutes&#46; A&#46; This high-density activation map was produced with the PMF and the PentaRay catheter and included 547 points&#44; resulting in a very detailed and accurate map&#46; B&#46; Standard activation map performed without PMF&#46; Points were collected with the ablation catheter and required manual validation&#44; resulting in fewer points being collected in the same amount of time &#8211; 42 points&#46; Also&#44; the bipolar endocardial electrogram had a lower voltage amplitude signal with larger electrogram duration compared to the bipolar electrogram acquired with the PentaRay catheter&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">CA&#58; coronary angiography&#59; LCC&#58; left coronary cusp&#59; LVEF&#58; left ventricular ejection fraction&#59; NCC&#58; non-coronary cusp&#59; PVC&#58; premature ventricular contraction&#59; RCC&#58; right coronary cusp&#59; RF&#58; radiofrequency&#59; RVOT&#58; right ventricular outflow tract&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Gender&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PVC number&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">LVEF &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Site of origin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Points acquired&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RF time&#44; sec&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Procedure time&#44; min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Acute success&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Complications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PVC follow-up&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">LVEF &#37;follow-up&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ROVT&#44; near His bundle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">816 &#40;379 RV and 437 LV&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">310&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Beneath LCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">308&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">240&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Beneath LCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">349&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">189&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">502&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anterolateral papillary muscle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">766&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">396&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1680&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Aortic mitral continuity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">306&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">303&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 240&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">RCC-NCC commissure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">456&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">440&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">547&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">400&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 591&#177;11 974&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#177;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">507&#177;213&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">294&#177;112&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67&#177;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2607157.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Procedure data from the Pattern Matching Filter software with PentaRay catheter&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">CA&#58; coronary angiography&#59; LCC&#58; left coronary cusp&#59; LVEF&#58; left ventricular ejection fraction&#59; PVC&#58; premature ventricular contraction&#59; RCC&#58; right coronary cusp&#59; RF&#58; radiofrequency&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Gender&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PVC number&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">LVEF &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Site of origin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Points acquired&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RF time&#44; sec&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Procedure time&#44; min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Acute success&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Complications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PVC follow-up&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">LVEF &#37;follow-up&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Aortic mitral continuity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">104&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">440&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">233&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">180&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">RCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">164&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1584&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">24 000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">43&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Posteromedial papillary muscle&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">620&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">130&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">None&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">130&#177;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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