ArticleHeart rhythm2020
Evaluation of the reentry vulnerability index to predict ventricular tachycardia circuits using high-density contact mapping.
Article in Heart rhythm, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Advancements in mapping, cardiac imaging, and ablation techniques for the management of ventricular tachycardias.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Review
- Detecting Local Myocardial Spatiotemporal Repolarization Gradients With Clinical Mapping Arrays.Circulation. Arrhythmia and electrophysiology · 2025Article
- Machine learning approach for automated localization of ventricular tachycardia ablation targets from substrate maps: development and validation in a porcine model.European heart journal. Digital health · 2025Article
- Repolarization time map in catheter ablation for scar-related reentrant ventricular tachycardia.Journal of arrhythmia · 2025Article
- Catheter Ablation for Ventricular Tachycardias: Current Status and Future Perspectives.Journal of clinical medicine · 2024Article
- High-density isochronal repolarization mapping and re-entry vulnerability estimation for scar-related ventricular tachycardia ablation: mechanistic basis, clinical application, and challenges.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 · 2024Review
- 3D-targeted, electrocardiographic imaging-aided stereotactic radioablation for ventricular tachycardia storm: a case report.European heart journal. Case reports · 2024Article
- Visualizing Reentry Vulnerable Targets During Scar-Related VT Ablation: A Novel Functional Substrate Mapping Approach Integrating Conduction and Repolarization Metrics.Circulation. Arrhythmia and electrophysiology · 2024Article
- Chemical ablation of the left ventricular endocardium reduces ventricular fibrillation inducibility in acute ischemic canine heart.Journal of arrhythmia · 2024Article
- Functional Substrate Mapping: A New Frontier in the Treatment of Ventricular Tachycardia in Structural Heart Disease.Arrhythmia & electrophysiology review · 2024Review
- Computer-aided detection of arrhythmogenic sites in post-ischemic ventricular tachycardia.Scientific reports · 2023Article
- Ventricular Conduction Stability Noninvasively Identifies an Arrhythmic Substrate in Survivors of Idiopathic Ventricular Fibrillation.Journal of the American Heart Association · 2023Article
- Fat deposition and repolarization: another brick in the wall promoting ventricular tachycardia?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 · 2023Article
- Basis and applicability of noninvasive inverse electrocardiography: a comparison between cardiac source models.Frontiers in physiology · 2023Review
- Unexpected impairment ofNature cardiovascular research · 2023Article
- Repolarization Heterogeneity in Human Post-Infarct Ventricular Tachycardia.JACC. Clinical electrophysiology · 2022Article
- Effect of scar and pacing location on repolarization in a porcine myocardial infarction model.Heart rhythm O2 · 2022Article
- Determining anatomical and electrophysiological detail requirements for computational ventricular models of porcine myocardial infarction.Computers in biology and medicine · 2022Article
- Impact of a high-density grid catheter on long-term outcomes for structural heart disease ventricular tachycardia ablation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2021Article
- Dynamic spatial dispersion of repolarization is present in regions critical for ischemic ventricular tachycardia ablation.Heart rhythm O2 · 2021Article
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Authors and funding
20 authors.
Funding
Abstract
backgroundIdentifying arrhythmogenic sites to improve ventricular tachycardia (VT) ablation outcomes remains unresolved. The reentry vulnerability index (RVI) combines activation and repolarization timings to identify sites critical for reentrant arrhythmia initiation without inducing VT.
objectiveThe purpose of this study was to provide the first assessment of RVI's capability to identify VT sites of origin using high-density contact mapping and comparison with other activation-repolarization markers of functional substrate.
methodsEighteen VT ablation patients (16 male; 72% ischemic) were studied. Unipolar electrograms were recorded during ventricular pacing and analyzed offline. Activation time (AT), activation-recovery interval (ARI), and repolarization time (RT) were measured. Vulnerability to reentry was mapped based on RVI and spatial distribution of AT, ARI, and RT. The distance from sites identified as vulnerable to reentry to the VT site of origin was measured, with distances <10 mm and >20 mm indicating accurate and inaccurate localization, respectively.
resultsThe origins of 18 VTs (6 entrainment, 12 pace-mapping) were identified. RVI maps included 1012 (408-2098) (median, 1st-3rd quartiles) points per patient. RVI accurately localized 72.2% VT sites of origin, with median distance of 5.1 (3.2-10.1) mm. Inaccurate localization was significantly less frequent for RVI than AT (5.6% vs 33.3%; odds ratio 0.12; P = .035). Compared to RVI, distance to VT sites of origin was significantly larger for sites showing prolonged RT and ARI and were nonsignificantly larger for sites showing highest AT and ARI gradients.
conclusionRVI identifies vulnerable regions closest to VT sites of origin. Activation-repolarization metrics may improve VT substrate delineation and inform novel ablation strategies.
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