Congenital heart diseaseDiagnostic or prognostic study
Automated isochronal late activation mapping for substrate characterization in patients with repaired tetralogy of Fallot
- Diagnostic accuracy study
- consecutive patients
Authors' conclusion
Deceleration zones displayed by ILAM during sinus rhythm accurately identify SC-AIs in rTF patients allowing a safe and short-time VT substrate characterization procedure.
Study context
- Population
- Patients with repaired tetralogy of Fallot undergoing ventricular tachycardia (VT) substrate characterization2 spontaneous VT, 12 risk stratification
- Participants
- 14 patients
- Comparison
- Isochronal late activation maps (ILAM) deceleration zones vs conduction velocity (CV)-defined SC-AI
- Outcome
- Identification of SC-AI by ILAM deceleration zones
Performance
As reported in the abstract
Identification of SC-AI by DZs on ILAM (vs CV <0.5 m/s)
Sensitivity
90%
Specificity
100%
Accuracy
0.94
Further findings
Substrate mapping: anatomical isthmuses
- Anatomical isthmuses (AIs) identified (all patients ≥1 AI)
- 27
- SC-AIs
- 11
- Deceleration zones (DZs) detected by ILAM
- 10
- DZs in AI between VSD and pulmonary valve
- 80%
- Patients with no DZs
- 5
Correlation of isochrones/cm with CV
- Significant negative correlation (rho)
- −0.87
- P
- P < 0.001
Procedure and mapping time
- Procedure time, min (p25-75 133-180)
- 140
- Mapping time, min (p25-75 20-37.7)
- 29.5
- Median points
- 2167
VT inducibility
- VTs inducible
- 9
- Patients with inducible VT
- 7
- DZs related to VT inducibility
- P = 0.006
- DZs co-localized to critical isthmus of induced VTs
- 88%
Safety
Complications
- No complications observed
Original publication
Automated isochronal late activation mapping for substrate characterization in patients with repaired tetralogy of Fallot. Europace. Published 26 March 2024. doi:10.1093/europace/euae062
Summarised from the published abstract; every number is checked against it