Ventricular substrate characteristics using omnipolar technology-derived vector disarray and peak frequency
Bibliographic record
Abstract
Abstract Background Three-dimensional electroanatomic mapping and ablation of ventricular tachycardias (VT) is a complex process that integrates data from multiple procedural steps, including substrate and activation mapping. Purpose To streamline diagnostic and therapeutic interventions, we applied the omnipolar near-field technology algorithm, with the goal of integrating it into the study of low-voltage areas, deceleration zones (DZs), areas of vector disarray (in sinus rhythm, SR), and critical VT isthmus sites. Methods In this single-center retrospective study, three-dimensional electroanatomic maps in SR of 35 patients (August 2023 to August 2024) were analysed. Substrate analysis focused on identifying low-voltage areas, late potentials, local abnormal ventricular activities (LAVAs), and DZs. Procedures were performed using the EnSite X Cardiac Mapping System (Abbott) with the Advisor HD Grid Mapping Catheter (Abbott). Radiofrequency lesions were delivered when clinically indicated. To quantify vector disarray, we analysed low voltage areas (range 0.04-1.50 mV) displaying omnipolar vectors, and the percentage of disarrayed vectors was calculated manually. Maps were compared via emphasis maps, integrating information from VT and SR maps. Results Over a 12-month period, 10 patients (5 female) underwent transcatheter ventricular mapping procedures for diagnostic purposes, and 25 patients (2 female) underwent VT ablation. Median age was 70 (IQR 54-74) years, with 19 (55.29%) patients with a history of ischemic heart disease. The primary procedure indications were electrical storm in 12 (34.29%), and sustained VT in 13 (37.14%) patients. The approach was endocardial in 30 patients, epicardial in 2, and combined endo-epicardial in 3 patients. The median highest peak frequency (PF) in the SR substrate maps within low-voltage areas was 280 (250-315) Hz. Median vector disarray was 60.27% (51.7-67.9), without significant differences between ischaemic and non-ischaemic cardiomyopathies (p=0.070). Low-voltage areas of VT interest displayed higher peak frequencies and greater vector disarray. Regions with PF above 250 Hz would overlap with chaotic vector areas and low-voltage areas in the majority of patients (82.4% and 85.3% respectively). Among patients with and without area overlap, there were no statistically significant differences in disease type, vector disarray percentage, age, and LVEF, while patients with overlapping areas had significantly larger high-frequency regions (p=0.005 and p=0.006, respectively). Conclusion During sinus rhythm, localisation of areas with increased PF and chaotic and low-voltage areas is frequent, and may aid in the identification of colliding wavefronts in low-voltage tissues during SR, thus characterising a possible arrhythmic substrate. Future studies are needed to investigate its potential advantages to limit the requirement for VT activation mapping.Characteristics of the study population OTNF and vector disarray in SR and VT
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| 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".