Atrial Endocardial Unipolar Voltage Mapping for Detection of Viable Intramural Myocardium: A Proof-of-Concept Study Article Swipe
YOU?
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· 2023
· Open Access
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· DOI: https://doi.org/10.1161/circep.122.011321
Background: Endocardial bipolar voltage amplitude is largely derived from endocardial and subendocardial wall layers. This may result in situations of low bipolar voltage amplitude despite the presence of mid-myocardial including epicardial (ie, intramural-epicardial) viable myocardium. This study examined the utility of endocardial unipolar voltage mapping for detection of viable intramural-epicardial atrial myocardium. Methods: In 15 swine, an atrial intercaval ablation line with an intentional gap was created. Animals survived for 6 to 8 weeks before electroanatomical mapping followed by sacrifice. Gaps were determined by the presence of electrical conduction and classified based on the histopathologiclly layer(s) of viable myocardium into the following: (1) transmural, (2) endocardial, and (3) intramural-epicardial. Voltage data from healthy, scar, and gap points were exported into excel. The sensitivity and specificity of bipolar and unipolar voltage amplitude to detect intramural-epicardial gaps were compared using receiver operating characteristic analysis. Results: In 9 of 15 (60%) swine, a focal ablation gap was detected in the intercaval line, while in the remainder 6 of 15 (40%), the line was complete without gaps. Gaps were classified into transmural (n=3), endocardial (n=3), or intramural-epicardial (n=3). Intramural-epicardial gaps were characterized by very low bipolar voltage amplitude that was similar to areas with transmural scar ( P =0.91). In comparison, unipolar voltage amplitude in intramural-epicardial gaps was significantly higher compared to transmural scar ( P <0.001). Unipolar voltage amplitude had higher sensitivity (93% versus 14%, respectively) and similar specificity (95% versus 98%, respectively) to bipolar voltage for detection of intramural-epicardial gaps. Conclusions: Atrial unipolar voltage mapping may be a useful technique for identifying viable intramural-epicardial myocardium in patients with endocardial scar.
Related Topics
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1161/circep.122.011321
- https://www.ahajournals.org/doi/pdf/10.1161/CIRCEP.122.011321
- OA Status
- bronze
- Cited By
- 11
- References
- 10
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4313458578
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4313458578Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1161/circep.122.011321Digital Object Identifier
- Title
-
Atrial Endocardial Unipolar Voltage Mapping for Detection of Viable Intramural Myocardium: A Proof-of-Concept StudyWork title
- Type
-
articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-01-01Full publication date if available
- Authors
-
Hagai Yavin, Arwa Younis, Israel Zilberman, Alison Krywanczyk, Zachary P. Bubar, Koji Higuchi, Michael Barkagan, Elad AnterList of authors in order
- Landing page
-
https://doi.org/10.1161/circep.122.011321Publisher landing page
- PDF URL
-
https://www.ahajournals.org/doi/pdf/10.1161/CIRCEP.122.011321Direct link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
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bronzeOpen access status per OpenAlex
- OA URL
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https://www.ahajournals.org/doi/pdf/10.1161/CIRCEP.122.011321Direct OA link when available
- Concepts
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Endocardium, Ablation, Cardiology, Internal medicine, Amplitude, Medicine, Physics, Quantum mechanicsTop concepts (fields/topics) attached by OpenAlex
- Cited by
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11Total citation count in OpenAlex
- Citations by year (recent)
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2025: 6, 2024: 4, 2023: 1Per-year citation counts (last 5 years)
- References (count)
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10Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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