Arrhythmias & electrophysiology
Characterization of conduction system activation in the postinfarct ventricle using ripple mapping
Authors' conclusion
Patients with broader QRS had fewer LV breakout sites from the conduction system. However, there was 3D mapping evidence of LV breakout from an intact conduction system in the majority of patients with LBBB.
Study context
- Population
- Patients undergoing VT ablation with postinfarct left ventricle (LV), mapped during normal rhythm
- Participants
- 15 vs 22
- Comparison
- Left anterior fascicle (LAF) vs left posterior fascicle (LPF); Left bundle branch block (LBBB) vs no LBBB
- LAFn = 15
- LPFn = 22reference
- Outcome
- Ripple-mapping characterization of LV conduction system activation (Purkinje potentials)
Methodological detailshigh-density mapping (PentaRay, CARTO)
- High-density mapping (PentaRay, CARTO)
Main finding
As reported in the abstract
| Group | Value | Length | Activation duration |
|---|---|---|---|
| LAF | 63% | 41.4 mm | 40.6 ms |
| LPF | 92% | 68.8 mm | 64.9 ms |
Value
LAF63%
LPF92%
Length
LAF41.4 mm
LPF68.8 mm
Activation duration
LAF40.6 ms
LPF64.9 ms
- LAF vs LPF: P = 0.0005 — length 41.4 vs 68.8 mm
- LAF vs LPF: P = 0.002 — activation duration 40.6 vs 64.9 ms
- Points per map (mean ± SD)
- 3112 ± 613
- Purkinje potentials per map
- 150.9 ± 24.5
Further findings
| Outcome | Values | P value |
|---|---|---|
| Purkinje potential-associated breakout in LBBB | LBBB 78% | |
| Breakouts from conduction system, LBBB vs no LBBB1.8 vs 3.4; 1.6 ± 0.6 | P = 0.039 |
- Purkinje potential-associated breakout in LBBB: 14 of 24 patients had LBBB
Breakout sites vs QRS duration
- Inverse correlation between breakout sites and QRS duration
- P = 0.0035
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Characterization of conduction system activation in the postinfarct ventricle using ripple mapping. Heart Rhythm. Published 28 January 2024. doi:10.
Summarised from the published abstract; every number is checked against it