Three-dimensional retrograde atrial activation maps obtained during atrioventricular nodal re-entrant tachycardia provides insights into the location of nodal inputs
Bibliographic record
Abstract
Three patients who had three-dimensional (3D) atrial local activation time maps measuring ventriculo-atrial intervals during atrioventricular node re-entrant tachycardia (AVNRT) were identified. Three-dimensional mapping of the clinical tachycardia was performed with the Ensite Nav-X system (St Jude Medical, St Paul, MN, USA). Patients 1 and 2 presented with typical slow–fast AVNRT. Earliest atrial activation (fast pathway) was localized at the left-atrial superior septal position, the right-sided His Bundle, and at the antero-superior aspect of the coronary sinus (CS) os. Patient 3 presented with atypical slow–slow AVNRT. Earliest atrial activation (see figure) was located antero-superiorly to the CS os. In all patients, successful slow pathway modification was achieved antero-inferior to the CS os. Our findings highlight the need to consider non-traditional anatomical sites of atrioventricular node inputs. The earliest atrial activation site does not correspond well to the successful site of ablation in typical AVNRT. Our inability to localize continuous atrial activation during AVNRT despite extensive bi-atrial mapping confirms that the majority of the circuit may either be electrically quiescent or sub-endocardial. Conflict of interest: none declared. The full-length version of this report can be viewed at: http://www.escardio.org/communities/EHRA/publications/ep-case-reports/Documents/insights-into-location-of-nodal-inputs.pdf
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 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) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".