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Feasibility of Atrial Substrate Mapping During Atrial Pacing and Its Impact on the Omnipolar Voltage and the Peak-Frequency of Electrograms.
J Cardiovasc Electrophysiol
December 2024
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Introduction: Atrial pacing maps are often used as substitutes for sinus rhythm (SR) maps to expedite mapping procedures. However, the impact of this method on electrophysiological parameters has not been systematically examined. This study aimed to elucidate the advantages and limitations of atrial pacing maps.
View Article and Find Full Text PDFVector field heterogeneity as a novel omnipolar mapping metric for functional substrate characterization in scar-related ventricular tachycardias.
Heart Rhythm
November 2024
Institute for Cardiovascular Science, University College London, UK; St Bartholomew's Hospital, London, UK.
Background: Vector field heterogeneity (VFH) is a novel omnipolar metric to quantify local propagation heterogeneities that may identify functionally critical sites for ablation in scar-related ventricular tachycardia (VT).
Objective: This study aims to assess the diagnostic value of VFH to identify abnormal propagation patterns during ventricular substrate mapping and compare VFH in VT isthmus sites (IS), low-voltage bystander area (LVA) , and normal voltage areas (NVAa).
Methods: Substrate maps acquired with a 16-pole grid catheter in patients with scar-related VT were segmented into sites corresponding to IS, LVA, and NVA (defined as omnipolar voltages > and <1.
Dynamic Voltage Mapping of the Post-infarct Ventricular Tachycardia Substrate: A Practical Technique to Help Differentiate Scar from Borderzone Tissue.
Arrhythm Electrophysiol Rev
October 2024
Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital Liverpool, UK.
During catheter ablation of post-infarct ventricular tachycardia (VT), substrate mapping is used when VT is non-inducible or poorly tolerated. Substrate mapping aims to identify regions of slowly conducting myocardium (borderzone) within and surrounding myocardial scar for ablation. Historically, these tissue types have been identified using bipolar voltage mapping, with areas of low bipolar voltage (<0.
View Article and Find Full Text PDFThe effect of fixed and functional remodelling on conduction velocity, wavefront propagation, and rotational activity formation in atrial fibrillation.
Europace
October 2024
Electrophysiology Department, Barts Heart Centre, Barts Health NHS Trust, W Smithfield, London EC1A 7BE, UK.
Article Synopsis
- The study investigates the unclear pathophysiology of atrial fibrillation (AF), focusing on how scar tissue and conduction velocity (CV) affect electrical wavefronts in sinus rhythm (SR) and AF.
- Researchers analyzed data from 60 patients, finding that local activation times and voltage levels correlate, with enhanced CV heterogeneity often found in areas of low voltage.
- The findings suggest that CV dynamics influenced by scar tissue lead to varying wavefront propagation in SR and increased rotational activity during AF, highlighting potential new targets for ablation treatment.
Cavotricuspid Isthmus-Dependent Atrial Flutter. Beyond Simple Linear Ablation.
Rev Cardiovasc Med
January 2024
School of Doctorate, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain.
The demonstration of a peritricuspid circular movement with a zone of slow conduction in the cavotricuspid isthmus, together with the high efficacy of linear ablation and widely accepted acute endpoints, has established typical flutter as a disease with a well-defined physiopathology and treatment. However, certain aspects regarding its deeper physiopathology, ablation targets, and methods for verifying the results remain to be clarified. While current research efforts have primarily been focused on the advancement of effective ablation techniques, it is crucial to continue exploring the intricate electrophysiological, ultrastructural, and pharmacological pathways that underlie the development of atrial flutter.
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