ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2024
Detailed analysis of electrogram peak frequency to guide ventricular tachycardia substrate mapping.
Article in 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, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Substrate-Based Ablation Guided by Combined Fractionation and Frequency Analysis for Multiple and Unmappable Ventricular Tachycardias.Journal of arrhythmia · 2026Article
- Clinical outcomes of pulmonary vein isolation with mapping-guided optimization in persistent atrial fibrillation.Heart and vessels · 2026Article
- Three-Dimensional Perspective on Scar-Related Ventricular Tachycardia Substrate: Critical Conduction Abnormalities as Ablation Targets and Implications for Procedural Endpoints.Reviews in cardiovascular medicine · 2026Review
- Dominant Frequency Mapping as a Functional Tool for Substrate-Guided Ventricular Tachycardia Ablation.Journal of cardiovascular electrophysiology · 2026Article
- Near-field substrate analysis in ventricular tachycardia: a novel approach to identify the critical isthmus.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Single or multiple pulsed field applications: Intracardiac electrogram changes and implications for procedural end points.Heart rhythm O2 · 2026Article
- Revealing an intramural layered boundary in a case of ventricular tachycardia via window adjustment and peak frequency analysis.HeartRhythm case reports · 2026Article
- Accuracy of non-invasive electrocardiographic imaging in scar-dependent ventricular tachycardia: relationship to arrhythmogenic substrate and imaging defined scar.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 · 2026Article
- From signal analysis to clinical practice: the use of peak frequency in mapping and ablation.Frontiers in cardiovascular medicine · 2026Review
- Ablation Methods and Catheter Settings for Ventricular Tachycardia Ablation: A Bench to Bedside Review: Part 2.Arrhythmia & electrophysiology review · 2026Review
- Averaging real-time impedance enhances the prediction of steam pop risk and lesion characteristics.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 · 2025Article
- Evolution of Human Scar-Related Ventricular Tachycardia Mapping for Exploring Mechanisms of Reentry Circuits.Reviews in cardiovascular medicine · 2025Review
- Enhanced visualization of the atrioventricular annulus using peak frequency and open-window mapping in right-sided accessory pathway ablation.HeartRhythm case reports · 2025Article
- Integration of automated peak frequency annotation with voltage mapping for identifying ventricular tachycardia ablation sites.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Article
- Mapping Atrial Tachycardia Post-Pulmonary Vein Isolation Using the PulseSelect Catheter and Ensite NavX.Journal of arrhythmia · 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
Corrections and comments
- Erratum issued
Authors and funding
14 authors.
Funding
Abstract
aimsDifferentiating near-field (NF) and far-field (FF) electrograms (EGMs) is crucial in identifying critical arrhythmogenic substrate during ventricular tachycardia (VT) ablation. A novel algorithm annotates NF-fractionated signals enabling EGM peak frequency (PF) determination using wavelet transformation. This study evaluated the algorithms' effectiveness in identifying critical components of the VT circuit during substrate mapping. METHODS AND
resultsA multicentre, international cohort undergoing VT ablation was investigated. VT activation maps were used to demarcate the isthmus zone (IZ). Offline analysis was performed to evaluate the diagnostic performance of low-voltage area (LVA) PF substrate mapping. A total of 30 patients encompassing 198 935 EGMs were included. The IZ PF was significantly higher in sinus rhythm (SR) compared to right ventricular paced (RVp) substrate maps (234 Hz (195-294) vs. 197 Hz (166-220); P = 0.010). Compared to LVA PF, the IZ PF was significantly higher in both SR and RVp substrate maps (area under curve, AUC: 0.74 and 0.70, respectively). The LVA PF threshold of ≥200 Hz was optimal in SR maps (sensitivity 69%; specificity 64%) and RVp maps (sensitivity 60%; specificity 64%) in identifying the VT isthmus. In amiodarone-treated patients (n = 20), the SR substrate map IZ PF was significantly lower (222 Hz (186-257) vs. 303 Hz (244-375), P = 0.009) compared to amiodarone-naïve patients (n = 10). The ≥200 Hz LVA PF threshold resulted in an 80% freedom from VT with a trend towards reduced ablation lesions and radiofrequency times.
conclusionLVA PF substrate mapping identifies critical components of the VT circuit with an optimal threshold of ≥200 Hz. Isthmus PF is influenced by chronic amiodarone therapy with lower values observed during RV pacing.
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