Arrhythmias & electrophysiology
Detailed analysis of electrogram peak frequency to guide ventricular tachycardia substrate mapping
An erratum to this article was published (Europace, 26 Dec 2024 ↗)
Authors' conclusion
LVA PF substrate mapping identifies critical components of the VT circuit with an optimal threshold of ≥200 Hz. Isthmus PF is influenced by chronic amiodarone therapy with lower values observed during RV pacing.
Study context
- Population
- Patients undergoing ventricular tachycardia (VT) ablation
- Participants
- 30 patients198,935 electrograms (EGMs)
- Comparison
- Low-voltage area (LVA) peak frequency (PF) substrate mapping in sinus rhythm (SR) vs right ventricular paced (RVp) maps for identifying the VT isthmus
- Outcome
- Diagnostic performance of LVA PF substrate mapping in identifying the VT isthmus zone
Methodological detailsmulticentre, international, offline analysis
- Multicentre
- International
- Offline analysis
Performance
As reported in the abstract
LVA PF ≥200 Hz threshold for identifying the VT isthmus
| Test or model | AUC | Sensitivity | Specificity |
|---|---|---|---|
| SR | 0.74 | 69% | 64% |
| RVp | 0.70 | 60% | 64% |
AUC
SR0.74
RVp0.70
Sensitivity
SR69%
RVp60%
Specificity
SR64%
RVp64%
Further findings
IZ PF, SR vs RVp substrate maps
P = 0.010
| Outcome | P value |
|---|---|
| SR map IZ PF, amiodarone-treated vs amiodarone-naïve (subgroup) | P = 0.009 |
- SR map isthmus zone (IZ) PF, amiodarone-treated vs amiodarone-naïve (subgroup): Amiodarone-treated (n = 20) 222 (range 186–257) Hz
- SR map IZ PF, amiodarone-treated vs amiodarone-naïve (subgroup): Amiodarone-naïve (n = 10) 303 (range 244–375) Hz
Freedom from VT with ≥200 Hz LVA PF threshold
- Freedom from VT
- 80%
- Trend towards reduced ablation lesions and radiofrequency times
Original publication
Detailed analysis of electrogram peak frequency to guide ventricular tachycardia substrate mapping. Europace. Published 29 September 2024. doi:10.
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