Arrhythmias & electrophysiologyCohort study
Multiparametric Electrogram Feature Analysis for Ventricular Tachycardia Functional Extra-Stimulus Substrate Mapping
- multicenter, international ventricular tachycardia (VT) ablation cohort
Authors' conclusion
Functional ES mapping using EGM duration prolongation DeEP maps yielded the highest accuracy in defining the arrhythmogenic substrate. The inclusion of latency or annotation of NF EGM components does not improve functional substrate mapping accuracy.
Study context
- Population
- Patients undergoing VT ablationpatients included
- Participants
- Nineteen patients
- Exposure
- 6 functional extra-stimulus (ES) maps tested for accuracy in identifying the critical arrhythmogenic substrate
Main finding
As reported in the abstract
Area under the receiver-operating characteristic curve
Electrogram (EGM) duration-based decremental evoked potential (DeEP) map
0.804
AUC · ± 0.107
stimulus to the last deflection-based DeEP map
0.625
AUC · ± 0.173
- EGM duration-based DeEP map highest AUC
- P < 0.001
- Optimal decrement threshold 20 milliseconds (F1 score)
- P = 0.014
- Optimal decrement threshold 30 milliseconds (F1 score)
- P = 0.029
Observational data: associations, not effects.
Further findings
Automated near-field (NF) EGM annotation
- Did not improve accuracy with or without the inclusion of latency
Precision in lateral/basal regions
- Δ average precision, EGM duration DeEP map
- 0.24 ± 0.04; P < 0.001
- superior accuracy across almost all left ventricular locations
Original publication
Multiparametric Electrogram Feature Analysis for Ventricular Tachycardia Functional Extra-Stimulus Substrate Mapping. JACC Clin Electrophysiol. Published 22 January 2026. doi:10.1016/j.jacep.2025.11.006
Summarised from the published abstract; every number is checked against it