Arrhythmias & electrophysiology
Mapping the unseen: Programmed electrical stimulation to detect concealed conduction block
Authors' conclusion
Perpendicular pacing opposite to the direction of SR using premature stimuli is optimal for unmasking CB. PES may also reduce CB in patients who already exhibit complex activation patterns during SR.
Study context
- Population
- Patients undergoing high-resolution epicardial mapping at the middle of the right atrium (RA)
- Participants
- 40 patients
- Comparison
- Programmed electrical stimulation (PES) from the 4 sides of the mapping array at different frequencies vs sinus rhythm (SR)
- Outcome
- CBA%
Main finding
As reported in the abstract
P < 0.001
Further findings
| Outcome | SR | SR50 | S2200 | S2250 | P value | |
|---|---|---|---|---|---|---|
| CB severitySR vs S2200 · increased during S2200 | 18 (range [14-29]) ms | Not reported in the abstract | 46 (range [29-53]) ms | Not reported in the abstract | P < 0.001 | SR50, S2250: not reported in the abstract |
| Patients with increased CBA% over SR | Not reported in the abstract | 58% | 100% | Not reported in the abstract | SR, S2250: not reported in the abstract |
Increase in CBA% during S2250 by pacing direction
- Perpendicular to the direction of SR
- +7.3 [0.5-10.8]%
- Opposite to the direction of SR
- +7.4 [3.5-15.5]%
Original publication
Mapping the unseen: Programmed electrical stimulation to detect concealed conduction block. Heart Rhythm. Published 31 October 2025. doi:10.
Summarised from the published abstract; every number is checked against it