Arrhythmias & electrophysiology
Rate-Dependent Pacemap Matching in Scar-Related Ventricular Tachycardia: Impact of "TR Fusion" Phenomenon
Authors' conclusion
The rate of pacemapping can significantly alter morphologic score matching, with the most optimal match observed closest to VT CL. The onset of QRS complex morphology is influenced by superimposition of the preceding T-wave at faster rates, resulting in an underrecognized TR fusion phenomenon that may confound epicardial electrocardiographic criteria predicated upon the initial QRS slope and vector.
Study context
- Population
- Patients undergoing scar-related ventricular tachycardia (VT) ablation
- Participants
- 40 patients269 pacemapping (PMs)
- Comparison
- Pacemapping at cycle lengths (CLs) of 600 ms, 500 ms, 400 ms, 300 ms and VT CL
- Outcome
- Variability in PM score matching at different pacing rates
Main finding
As reported in the abstract
PM score improved at rates closer to VT; median difference between lowest and highest PM scores at a given site (Q1-Q3: 4%-10%; range: 0%-33%)
6%
Sites developing pseudo delta wave at faster PM rates
32%
Endocardial pacing sites fulfilling epicardial criteria at faster PM rates
69%
Original publication
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