Arrhythmias & electrophysiology
Evaluation of noninvasive isochronal late activation mapping in scar-related ventricular tachycardia with electrocardiographic imaging against contact mapping
Authors' conclusion
ECGI with last negative deflection detects late activation zones in most cases with a moderate sensitivity. Detailed functional substrate mapping including accurate localization of local DZs remains challenging, with low sensitivity, precluding its clinical use for this indication in its current form.
Study context
- Population
- Scar-related VT ablation patients27.7% ischemic, 72.3% nonischemic, epicardial data acquired in 30 (63.8%)
- Participants
- Forty-seven patients
- Comparison
- ECGI vs electroanatomic mapping (EAM) as gold-standard
- Outcome
- Absolute late activating areas
Methodological detailssegmental comparison
- Segmental comparison
Main finding
As reported in the abstract
- Latest electrogram was significantly later on EAM
- ECGI vs EAM: P = 0.161
Further findings
Patients with DZs identified
P = 0.5
| Outcome | ECGI | EAM | P value | |
|---|---|---|---|---|
| Detection of late activation (EAM as gold-standard) | ||||
| Sensitivity | 68% | Not reported in the abstract | EAM: not reported in the abstract | |
| Specificity | 95% | Not reported in the abstract | EAM: not reported in the abstract | |
| DZs per mapSignificantly more DZs per map with ECGI | mean 2.5 (SD 1.2) | mean 1.2 (SD 0.8) | P < 0.001 | |
| DZs per map | P < 0.001 |
- ECGI DZ mapping
- 46.8% · sensitivity · specificity 90.6%
- ECGI DZ mapping — interpolated and artificial deceleration zones (DZs) identified
- 95.7%
- DZs per map: 2.5 ± 1.2 vs 1.2 ± 0.8; less steep activation gradients with ECGI (P = .002)
- ECGI DZ mapping: in the context of a high number of total segments and preemptive exclusion of interpolated and artificial DZs
Original publication
Evaluation of noninvasive isochronal late activation mapping in scar-related ventricular tachycardia with electrocardiographic imaging against contact mapping. Heart Rhythm. Published 18 February 2025. doi:10.
Summarised from the published abstract; every number is checked against it