ArticleJournal of cardiovascular electrophysiology2017
Rotors exhibit greater surface ECG variation during ventricular fibrillation than focal sources due to wavebreak, secondary rotors, and meander.
Article in Journal of cardiovascular electrophysiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- In vivo mapping of human polymorphic ventricular tachycardia.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Article
- Distinct spectral dynamics of implanted cardiac defibrillator signals in spontaneous termination of polymorphic ventricular tachycardia and fibrillation in patients with electrical and structural diseases.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2022Article
- Credibility assessment of patient-specific computational modeling using patient-specific cardiac modeling as an exemplar.PLoS computational biology · 2022Article
- Forward-Solution Noninvasive Computational Arrhythmia Mapping: The VMAP Study.Circulation. Arrhythmia and electrophysiology · 2022Article
- Electrical Substrate Ablation for Refractory Ventricular Fibrillation: Results of the AVATAR Study.Circulation. Arrhythmia and electrophysiology · 2021Article
- Granger Causality-Based Analysis for Classification of Fibrillation Mechanisms and Localization of Rotational Drivers.Circulation. Arrhythmia and electrophysiology · 2020Article
- Statistical guidance of VT ablation.Journal of cardiovascular electrophysiology · 2018Article
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10 authors at 4 institutions in 1 country.
Funding
Abstract
introductionVentricular fibrillation is a common life-threatening arrhythmia. The ECG of VF appears chaotic but may allow identification of sustaining mechanisms to guide therapy. HYPOTHESIS: We hypothesized that rotors and focal sources manifest distinct features on the ECG, and computational modeling may identify mechanisms of such features.
methodsVF induction was attempted in 31 patients referred for ventricular arrhythmia ablation. Simultaneous surface ECG and intracardiac electrograms were recorded using biventricular basket catheters. Endocardial phase maps were used to mechanistically classify each VF cycle as rotor or focally driven. ECGs were analyzed from patients demonstrating both mechanisms in the primary analysis and from all patients with induced VF in the secondary analysis. The ECG voltage variation during each mechanism was compared. Biventricular computer simulations of VF driven by focal sources or rotors were created and resulting ECGs of each VF mechanism were compared.
resultsRotor-based VF exhibited greater voltage variation than focal source-based VF in both the primary analysis (n = 8, 110 ± 24% vs. 55 ± 32%, P = 0.02) and the secondary analysis (n = 18, 103 ± 30% vs. 67 ± 34%, P = 0.009). Computational VF simulations also revealed greater voltage variation in rotors compared to focal sources (110 ± 19% vs. 33 ± 16%, P = 0.001), and demonstrated that this variation was due to wavebreak, secondary rotor initiation, and rotor meander.
conclusionClinical and computational studies reveal that quantitative criteria of ECG voltage variation differ significantly between VF-sustaining rotors and focal sources, and provide insight into the mechanisms of such variation. Future studies should prospectively evaluate if these criteria can separate clinical VF mechanisms and guide therapy.
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