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dc.contributor.authorBhaskaran, Abhishek
dc.contributor.authorNayyar, Sachin
dc.contributor.authorPorta-Sanchez, Andreu 
dc.contributor.authorJons, Christian
dc.contributor.authorMassé, Stéphane
dc.contributor.authorMagtibay, Karl
dc.contributor.authorAukhojee, Prashant
dc.contributor.authorHa, Andrew
dc.contributor.authorBokhari, Mahmoud
dc.contributor.authorTung, Roderick
dc.contributor.authorDownar, Eugene
dc.contributor.authorNanthakumar, Kumaraswamy
dc.identifier.citationHeart Rhythm. 2020; 17(3):439-446es_ES
dc.description.abstractBACKGROUND: The ventricular tachycardia (VT) circuit is often assumed to be located in the endocardium or epicardium. The plateauing success rate of VT ablation warrants reevaluation of this mapping paradigm. OBJECTIVE: The purpose of this study was to resolve the intramural components of VT circuits by mapping in human hearts. METHODS: Panoramic simultaneous endocardial-epicardial mapping (SEEM) during intraoperative mapping (IOM) was performed in human subjects. In explanted hearts (EH), SEEM and intramural multielectrode plunge needle mapping (NM) of the left ventricle were performed. Overall, 37 VTs (26 ischemic cardiomyopathy [ICM], 11 nonischemic cardiomyopathy [NICM]) were studied in 32 patients. Intraoperative SEEM was performed in 16 patients (16 ICM). Additionally, 16 explanted myopathic human hearts (9 NICM, 7 ICM) were studied in a Langendorff setup. Predominant intramural location of the VT was imputed by the absence of significant endocardial-epicardial activation during IOM (using SEEM and no NM) or by the presence of intramural activation spanning the entire cycle length (including mid-diastole) in EH (SEEM and NM). RESULTS: By IOM (SEEM), predominant endocardial activation (entire tachycardia cycle length including mid-diastolic activation) was present in 10 of 18 VTs (55%). In 8 of 18 VTs (44%), the VT circuit was presumed to be intramural due to incomplete diastolic activation in endocardium and epicardium. In EH (SEEM and NM), VT location was predominantly intramural, endocardial, and epicardial in 8 of 19 (42%), 5 of 19 (26%), and 1 of 19 VTs (5%), respectively. CONCLUSION: In a significant proportion of both ischemic and nonischemic ventricular tachycardias, the predominant activation was located in the intramural space.es_ES
dc.description.sponsorshipThis work was funded by CIHR MOP: 142272. Dr Bhaskaran is a Burnett fellow. Dr Nanthakumar is an investigator at TGHRI and HSF.es_ES
dc.publisherElsevier es_ES
dc.subjectExplanted heart mappinges_ES
dc.subjectIntramural needle mappinges_ES
dc.subjectIntramural ventricular tachycardiaes_ES
dc.subjectIntraoperative mappinges_ES
dc.subjectVentricular tachycardia mappinges_ES
dc.titleDirect and indirect mapping of intramural space in ventricular tachycardiaes_ES
dc.typejournal articlees_ES
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.identifier.journalHeart rhythmes_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Cardiología Moleculares_ES
dc.rights.accessRightsopen accesses_ES

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Attribution-NonCommercial-NoDerivatives 4.0 Internacional
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