Novel real-time automation of combined frequency and low voltage substrate mapping to guide ablation for Brugada syndrome: a case report.

Joseph Mayer, Jaffar Al-Sheikhli, Maria Niespialowska-Steuden, Elijah Behr, Tarvinder Dhanjal

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Article in European heart journal. Case reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Joseph MayerHeart Rhythm Research Group, Division of Biomedical Sciences, Warwick Medical School, Clinical Sciences Research Laboratory, Clifford Bridge Road, Coventry CV2 2DX, UK.ORCID https://orcid.org/0000-0002-8882-7357

Jaffar Al-SheikhliHeart Rhythm Research Group, Division of Biomedical Sciences, Warwick Medical School, Clinical Sciences Research Laboratory, Clifford Bridge Road, Coventry CV2 2DX, UK.

Maria Niespialowska-SteudenUniversity Hospital of Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK.ORCID https://orcid.org/0000-0002-1839-9465

Elijah BehrCardiovascular Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St. George's University of London, Cranmer Terrace, London SW17 0RE, UK.

Tarvinder DhanjalHeart Rhythm Research Group, Division of Biomedical Sciences, Warwick Medical School, Clinical Sciences Research Laboratory, Clifford Bridge Road, Coventry CV2 2DX, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Brugada syndrome (BrS) is an inherited cardiac condition that increases the risk of sudden cardiac death (SCD) due to ventricular arrhythmias. Catheter ablation has been shown to effectively reduce recurrent ventricular fibrillation (VF) episodes through targeting of abnormal electrograms predominantly located within the anterior surface of the right ventricular outflow tract. Signal frequency mapping is an emerging concept that provides further definition of pathological ventricular substrate. Case summary: A 66-year-old male with BrS was admitted to our institution with implantable cardioverter defibrillator shocks for VF. Electro-anatomical mapping (EAM) and ablation were performed utilizing a novel automated frequency-based strategy. Combined automated frequency and low voltage maps were generated to define high frequency, low voltage (HF-LVo) depolarization abnormalities within the QRS complex. Low frequency, low voltage (LF-LVo) regions from the QRS terminal notch to the T-wave offset were also identified. The combined HF-LVo and LF-LVo map areas totalled 12.4 cm Discussion: Catheter ablation for BrS utilizing a novel automated combined frequency and low voltage EAM approach can objectively identify relevant substrate. The results demonstrate adequate substrate modification with comparable ablation target areas to previous studies and encouraging clinical outcomes.

Indexed as

Brugada syndromeCase reportCatheter ablationElectro-anatomical mappingVentricular arrhythmias

Identifiers

PMID39545156

DOI10.1093/ehjcr/ytae588

PMCPMC11561564

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