ArticleJournal of cardiovascular electrophysiology2026
Dominant Frequency Mapping as a Functional Tool for Substrate-Guided Ventricular Tachycardia Ablation.
Article in Journal of cardiovascular electrophysiology, 2026. 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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Abstract
introductionAccurate identification of arrhythmogenic substrate is essential for successful ventricular tachycardia (VT) ablation, yet existing electrogram-based methods are limited by far-field interference and operator dependence. Dominant frequency (DF) mapping offers a stimulus-independent alternative, but existing implementations lack anatomically integrated workflows with quantitative assessment of spatial concordance.
methodsThe objective of this study is to develop and evaluate a computational workflow for DF mapping with three-dimensional anatomical integration in patients undergoing substrate-guided VT ablation. We retrospectively analyzed 12 patients (mean age 57.5 ± 18.0 years; 75% male) with ischemic or non-ischemic cardiomyopathy. Intracardiac electrograms from SmartTouch or Pentaray catheters were segmented, transformed into the frequency domain, and thresholded using case-specific histograms. DF activity was projected onto patient-specific ventricular meshes, and spatial correspondence with operator-defined ablation sites was quantified using continuous proximity metrics (soft recall, soft precision) and receiver operating characteristic (ROC) analysis.
resultsDF analysis was successful in all cases, with projection errors < 4 mm. DF activity showed high soft recall (0.776-0.999) and variable soft precision (0.025-0.754). ROC AUC values ranged from 0.622 to 0.953, exceeding baseline in all cases. SmartTouch data generally yielded higher recall and greater separation between ablation and non-ablation points.
conclusionDF mapping with anatomical integration is feasible across catheter types and demonstrates consistent spatial concordance with operator-defined VT ablation targets. This stimulus-independent workflow can be applied to routine mapping data and provides a framework for quantitative assessment of spatial relationships with procedural targets. DF values were case-specific and not comparable across patients, catheter types, or institutions. Prospective evaluation in larger cohorts is warranted.
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