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- W2078732901 abstract "Introduction: Electrogram properties in the ventricular scar can identify information content specific to the location of ventricular tachycardia (VT) supporting channels and lead focused substrate ablation. Methods: Patients with ischaemic cardiomyopathy (ICM; n = 16) and multiple inducible VT (n = 58) undergoing catheter ablation were evaluated. Left ventricular mapping was performed in sinus rhythm (SR) with PentaRay™ catheter and NavX™ mapping system. High-density pace mapping in the scar and entrainment were used to identify VT channels. As an independent stage, a stepwise model of electrogram properties was applied to all SR maps: the timing of local activation was determined as mean of activation times of all electrogram peak deflections, dispersion was quantified by their standard deviation, and Shannon entropy in their amplitude distribution was calculated as an index of channel branching. Channel locations built on this model were evaluated against VT channels identified during initial mapping. For the test of concept, performance of this model was examined prospectively in four additional ICM patients to lead catheter ablation. Results: Mean 763 ± 203 sampling points were taken. From 1770 pacemaps, 174 channels were identified, 47 corresponded to inducible VTs. Channels built on the model had high agreement with VT channels [κ = 0.89, p < 0.0001] with high sensitivity (86%), specificity (100%), positive (93%) and negative (100%) predictive value for localising inducible VT channels, compared to conventional electrogram properties. Finally, focused ablation in four patients within the postulated channel regions eliminated 7/9 inducible VTs. Conclusion: High-density multiple deflections mapping accurately identifies VT channels. This can significantly advance the current substrate based VT ablation strategies." @default.
- W2078732901 created "2016-06-24" @default.
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- W2078732901 date "2013-01-01" @default.
- W2078732901 modified "2023-09-29" @default.
- W2078732901 title "A Deductive Strategy from Multiple Deflections Mapping in Sinus Rhythm for Field Localisation of Ventricular Tachycardia Supporting Channels in Ischaemic Cardiomyopathy" @default.
- W2078732901 doi "https://doi.org/10.1016/j.hlc.2013.05.219" @default.
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