Contact force mapping and voltage thresholds during high-frequency stimulation of human cardiac ganglionated plexuses
Bibliographic record
Abstract
AIMS: The intrinsic cardiac nervous system consists of ganglionated plexuses (GPs) localized epicardially to specific regions of the left atrium (LA). The relation between voltage thresholds and endocardial contact force associated with autonomic effects during stimulation of GPs has not previously been evaluated. METHODS AND RESULTS: Sixteen patients with symptomatic atrial fibrillation (AF) underwent mapping of GPs prior to radiofrequency ablation of AF. Pre-acquired computed tomographic images were merged with 3D non-fluoroscopic electroanatomic mapping of the LA. Using high-frequency stimulation (HFS), the voltage thresholds of GPs was obtained while patients received conscious sedation. At each location, the contact force measurement from the catheter was correlated with the voltage applied during HFS at 5, 10, or 15 V to obtain an autonomic effect, usually associated with asystole, or marked bradycardia. There were 192 applications of HFS, resulting in GP identification in all patients (mean 3.4 per patient, range 1-5). During HFS, an autonomic response was significantly more likely to occur at 10 V as compared with 5 V (P < 0.008). There was no significant relation between the measured contact force and the likelihood of obtaining an autonomic response. When performing HFS at 15 V, a sudden overshoot with maximal values of contact force of up to 100 g was also observed. High-frequency stimulation was well tolerated, without associated adverse events. CONCLUSION: An autonomic response during HFS was significantly more likely to occur at 10 V as compared with 5 V. Although the GPs are epicardial structures, significant contact force was not required for their localization.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".