Arrhythmias & electrophysiologyDiagnostic or prognostic study
Clinical validation of an in silico pace mapping approach to localize both focal and re-entrant ventricular arrhythmias in patients with structural heart disease
- Clinical validation of a near real-time in silico pace mapping (InSPM) approach
- personalized image-based computational models
Authors' conclusion
InSPM provides a rapid and validated personalized computational modeling ablation technology to accurately localize both focal and re-entrant VTs, which may be practically integrated into clinical workflows.
Study context
- Population
- Patients with structural heart disease undergoing clinical pace mapping and ventricular tachycardia (VT) inductionpatients, 270 clinical pace-mapping locations
- Participants
- 18 patients
- Comparison
- InSPM predicted target areas vs clinical pace-mapping ground truth sites (focal) and surrogates of VT site of origin and mapped VT circuits (re-entrant)
Performance
As reported in the abstract
Intrinsic resolution of clinical pace mapping
Intrinsic resolution for similarly correlated ECGs
approximately 4 mm
Mean correlation coefficient
>0.99
Further findings
Distance (d) between clinical ground truth sites and InSPM predicted target areas
- d across 270 clinical pace-mapping locations
- 8.2 mm (6.9-12 mm)
- Relatively insensitive to cardiomyopathy, but with increased accuracy in right vs left ventricles
Determinants of InSPM accuracy
- Patient-specific ECG electrodes alongside accurate scar representation, particularly in patients with ischemia, were important for optimizing InSPM accuracy
Re-entrant VT exit site identification
- InSPM created from clinical ECG VT templates reliably identified re-entrant VT exit sites
Original publication
Clinical validation of an in silico pace mapping approach to localize both focal and re-entrant ventricular arrhythmias in patients with structural heart disease. Heart Rhythm. Published 19 May 2026. doi:10.1016/j.hrthm.2026.05.023
Summarised from the published abstract; every number is checked against it