Arrhythmias & electrophysiologyCross-sectional study
Comparing High-Density Electroanatomic Mapping and MRI
- multicenter, observational, cross-sectional study
Authors' conclusion
EVM had high agreement with LGE-CMR images and accurately delineated endo-mid-myocardial substrates, supporting its potential role in substrate characterization for NICM patients unfit for LGE-CMR.
Study context
- Population
- Nonischemic cardiomyopathy (NICM) patients who underwent left ventricular electroanatomic voltage mapping (EVM) for arrhythmic and sudden cardiac death (SCD) risk stratification, each also undergoing late gadolinium enhancement cardiac magnetic resonance (LGE-CMR)
- Participants
- 36 NICM patients
- Exposure
- concordance and reliability between LGE-CMR-derived scar maps and EVM performed with a high-density catheter in myocardial tissue characterization
Main finding
As reported in the abstract
Agreement with subepicardial LGE-CMR maps
| Group | κ | PPV | NPV |
|---|---|---|---|
| Unipolar (UNI) | 0.93 | 97.2% | 86.5% |
Observational data: associations, not effects.
Further findings
| Outcome | OT | BIP | UNI | LGE-CMR |
|---|---|---|---|---|
| Agreement for subendocardial layers | ||||
| κ | 0.97 | 0.74 | Not reported in the abstract | Not reported in the abstract |
| PPV | 96% | 76% | Not reported in the abstract | Not reported in the abstract |
| NPV | 100% | 96% | Not reported in the abstract | Not reported in the abstract |
Agreement for subendocardial layers
- Omnipolar technology (OT) outperformed bipolar (BIP) for subendocardial layers
Reliability (Bland-Altman) with LGE-CMR-derived scar maps
- OT showed the least systematic bias and the narrowest limits of agreement, and was associated with higher point density maps
Best-aligned myocardial layer
- BIP mapping had the best agreement with the 10%-20% myocardial layer
- OT best aligned with the 20%-40% myocardial layer
Original publication
Comparing High-Density Electroanatomic Mapping and MRI. JACC Clin Electrophysiol. Published 11 March 2026. doi:10.1016/j.jacep.2026.01.054
Summarised from the published abstract; every number is checked against it