The DOI matches its Crossref record; 13 of the 13 references it cites were found in a registry or an index.
Electrically Unexcitable Scar Mapping Based on Pacing Threshold for Identification of the Reentry Circuit Isthmus: Feasibility for Guiding Ventricular Tachycardia Ablation
Abstract
Background— We hypothesized that delineating electrically unexcitable scar (EUS) within low-voltage infarct regions will locate reentry circuit isthmuses by defining their borders. The pacing threshold and electrogram amplitude that best determines EUS is unknown. Methods and Results— The change in dimension of the virtual electrode was estimated in 11 patients and observed to increase by 4.4±2.5 mm as stimulus strength increases from threshold (2.9±1.8 mA) to 10 mA. EUS was defined as a threshold >10 mA. In 14 consecutive patients, mapping and ablation of ventricular tachycardia (VT) were performed using an electroanatomic mapping system. During sinus rhythm, unipolar pacing was performed at sites with bipolar electrogram amplitude <1.5 mV. EUS regions were marked on the maps. Reentry circuit isthmuses were identified by entrainment mapping or pace mapping, and ablation was performed. EUS was identified in the infarct in all 14 patients (11.8±13.9 cm 2 ). All 20 VT circuit isthmuses identified were adjacent to EUS. Although electrogram amplitude correlated with pacing threshold ( r =0.64, P <0.0001), many isthmuses had very low-amplitude electrograms, and EUS could not be identified from electrogram amplitude alone. RF ablation lines connecting selected EUS regions abolished all inducible VTs in 10 patients (71%); spontaneous VT was markedly reduced during follow-up (from 142±360 to 0.9±2.0 episodes per month, P =0.002). Conclusions— This new method of identifying EUS provides complimentary information to the electrogram amplitude in delineating potential reentry circuit paths, potentially facilitating ablation during sinus rhythm.
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Cites
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Self-citationSlow conduction in the infarcted human heart. 'Zigzag' course of activation.
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EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias
Aliot, E. M., Stevenson, W. G., Almendral-Garrote, J. M., Bogun, F., Calkins, C. H., Delacretaz, E., Della Bella, P., Hindricks, G., Jaïs, P., Josephson, M. E., et al. (2009) · Heart Rhythm · doi:10.1016/j.hrthm.2009.04.030 · Cited by 770
Self-citationStevenson, W. G., Wilber, D. J., Natale, A., Jackman, W. M., Marchlinski, F. E., Talbert, T., Gonzalez, M. D., Worley, S. J., Daoud, E. G., Hwang, C., et al. (2008) · Circulation · doi:10.1161/circulationaha.108.788604 · Cited by 732
Self-citationCardiac fibrosis – A short review of causes and therapeutic strategies
Hinderer, S., & Schenke-Layland, K. (2019) · Advanced Drug Delivery Reviews · doi:10.1016/j.addr.2019.05.011 · Cited by 490
Soejima, K., Stevenson, W. G., Sapp, J. L., Selwyn, A. P., Couper, G., & Epstein, L. M. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.01.029 · Cited by 485
Self-citation2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias
Cronin, E. M., Bogun, F. M., Maury, P., Peichl, P., Chen, M., Namboodiri, N., Aguinaga, L., Leite, L. R., Al-Khatib, S. M., Anter, E., et al. (2020) · Heart Rhythm · doi:10.1016/j.hrthm.2019.03.002 · Cited by 431
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Metadata
- Authors
- Soejima, K., Stevenson, W. G., Maisel, W. H., Sapp, J. L., & Epstein, L. M.
- Venue
- Circulation
- Published
- 2002-09-24
- Volume
- 106
- Issue
- 13
- Pages
- 1678-1683
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2121975209
- Cited by
- 342
- References
- 13
- FWCI
- 5.61
- Type
- journal article
- Language
- en
- Open access
- closed
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- Soejima, K., Stevenson, W. G., Maisel, W. H., Sapp, J. L., & Epstein, L. M. (2002). Electrically Unexcitable Scar Mapping Based on Pacing Threshold for Identification of the Reentry Circuit Isthmus: Feasibility for Guiding Ventricular Tachycardia Ablation. Circulation. https://doi.org/10.1161/01.cir.0000030187.39852.a7
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