Arrhythmias & electrophysiology
Near-field detection and peak frequency metric for substrate and activation mapping of ventricular tachycardias in two- and three-dimensional circuits
Authors' conclusion
The NF algorithm may enable rapid high-density activation mapping of VT circuits in the NF of the mapped surface.
Study context
- Population
- Patients with scar-related re-entry ventricular tachycardia (VT) with high-density VT activation and substrate maps (55.6% ischaemic)
- Participants
- 18 patients
- Exposure
- Automated near-field (NF) detection algorithm vs manually reviewed maps
- Outcome
- Correct localisation of critical parts of the VT circuit by NF detection vs manually reviewed VT maps
Methodological detailsCritical sites confirmed by activation mapping with entrainment and/or VT termination with radiofrequency (RF) ablation
- Critical sites confirmed by activation mapping with entrainment and/or VT termination with RF ablation
Main finding
As reported in the abstract
Critical parts of VT circuit correctly located
NF
77.7%
Observational data: associations, not effects.
Further findings
| Outcome | NF | FDcorr | LD | |
|---|---|---|---|---|
| Deceleration zones on substrate maps | ||||
| DZ identified | 88.8% | Not reported in the abstract | Not reported in the abstract | FDcorr, LD: not reported in the abstract |
| DZ overlap with FDcorr VT isthmus | 72.2% | Not reported in the abstract | Not reported in the abstract | FDcorr, LD: not reported in the abstract |
- Deceleration zones on substrate maps: Manual review deceleration zones (DZ) (last deflection (LD)) overlap with FDcorr VT isthmus 83.3%
Peak frequency (PF) on substrate maps, isthmus vs low-voltage bystander sites
- PF as a stand-alone feature did not differentiate VT isthmus sites from low-voltage bystander sites
Omnipolar voltage, isthmus vs low-voltage bystander sites
- Omnipolar voltage significantly higher at isthmus sites with longer electrogram (EGM) durations vs low-voltage bystander sites
Original publication
Near-field detection and peak frequency metric for substrate and activation mapping of ventricular tachycardias in two- and three-dimensional circuits. Europace. Published 4 June 2024. doi:10.
Summarised from the published abstract; every number is checked against it