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. 2022 Aug;33(8):1791-1800.
doi: 10.1111/jce.15611. Epub 2022 Jul 8.

Temporal and spatial pacemap parameters for identification of cardiac surfaces with critical sites for ventricular tachycardia

Akiko Ueda  1 , Yumi Katsume  2 , Yosuke Miwa  2 , Takato Mohri  2 , Mika Tashiro  2 , Noriko Nonoguchi  2 , Kyoko Hoshida  2 , Ikuko Togashi  1 , Toshiaki Sato  1 , Kyoko Soejima  2 ; other members of the Multi-surface PM study Group
Affiliations

Temporal and spatial pacemap parameters for identification of cardiac surfaces with critical sites for ventricular tachycardia

Akiko Ueda et al. J Cardiovasc Electrophysiol. 2022 Aug.

Abstract

Introduction: Multisurface pacemapping may help identify the surface of interest in scar-related ventricular tachycardia (VT). This study aimed to investigate the performance of pacemap parameters for detecting critical sites through multisurface mapping.

Methods and results: In 26 patients who underwent scar-related VT ablation, pacemap parameters including a matching score, the difference between the longest and shortest stimulus-QRS intervals (Δs-QRS), and the distance between the good pacemap sites were measured. The parameters were compared between surfaces with and without critical sites and ablation outcomes. A total of 941 pacemap at 56 surfaces targeting 35 VTs were analyzed. A greater Δs-QRS (40 vs. 8 ms, p < .001) and longer distance between two good pacemap sites (24 vs. 13 mm, p < .001) were observed on the surfaces with critical sites. A similar trend was seen in multisurface pacemapping for the same VTs (52 vs. 18 ms in Δs-QRS, p = .021; 37 vs. 12 mm in distance, p = .019), although the best pacemap scores were comparable (94 vs. 87, p = .295). The Δs-QRS > 20 ms and the distance >19 mm showed high positive likelihood ratios (19.8 and 6.1, respectively) for discriminating the surface harboring the critical site. Ablation of VTs fulfilling these parameters was successful on the surfaces, but without the required multisurface ablation.

Conclusion: Temporal (Δs-QRS) and spatial (distance) parameters for good pacemap match sites were excellent markers for detecting the surface harboring critical sites in scar-related VT. A multisurface pacemapping can successfully identify the surface of interest.

Keywords: pacemapping; spatial parameters; surface of interest; temporal parameters; three-dimensional ventricular tachycardia.

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References

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