{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T09:23:48Z","timestamp":1780478628496,"version":"3.54.1"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T00:00:00Z","timestamp":1603238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["PG\/15\/20\/31339"],"award-info":[{"award-number":["PG\/15\/20\/31339"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims\u2003<\/jats:title>\n                  <jats:p>Rate adaptation of the action potential ensures spatial heterogeneities in conduction across the myocardium are minimized at different heart rates providing a protective mechanism against ventricular fibrillation (VF) and sudden cardiac death (SCD), which can be quantified by the ventricular conduction stability (V-CoS) test previously described. We tested the hypothesis that patients with a history of aborted SCD due to an underlying channelopathy or cardiomyopathy have a reduced capacity to maintain uniform activation following exercise.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results\u2003<\/jats:title>\n                  <jats:p>Sixty individuals, with (n\u2009=\u200928) and without (n\u2009=\u200932) previous aborted-SCD event underwent electro-cardiographic imaging recordings following exercise treadmill test. These included 25 Brugada syndrome, 13 hypertrophic cardiomyopathy, 12 idiopathic VF, and 10 healthy controls. Data were inputted into the V-CoS programme to calculate a V-CoS score that indicate the percentage of ventricle that showed no significant change in ventricular activation, with a lower score indicating the development of greater conduction heterogeneity. The SCD group, compared to those without, had a lower median (interquartile range) V-CoS score at peak exertion [92.8% (89.8\u201396.3%) vs. 97.3% (94.9\u201399.1%); P\u2009&amp;lt;\u20090.01] and 2\u2009min into recovery [95.2% (91.1\u201397.2%) vs. 98.9% (96.9\u201399.5%); P\u2009&amp;lt;\u20090.01]. No significant difference was observable later into recovery at 5 or 10\u2009min. Using the lowest median V-CoS scores obtained during the entire recovery period post-exertion, SCD survivors had a significantly lower score than those without for each of the different underlying aetiologies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion\u2003<\/jats:title>\n                  <jats:p>Data from this pilot study demonstrate the potential use of this technique in risk stratification for the inherited cardiac conditions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euaa248","type":"journal-article","created":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T20:28:53Z","timestamp":1597782533000},"page":"305-312","source":"Crossref","is-referenced-by-count":10,"title":["Non-invasive detection of exercise-induced cardiac conduction abnormalities in sudden cardiac death survivors in the inherited cardiac conditions"],"prefix":"10.1093","volume":"23","author":[{"given":"Kevin Ming Wei","family":"Leong","sequence":"first","affiliation":[{"name":"Institute of Cardiovascular Science, University College London & Bart's Heart Centre, Bart's Health NHS Trust, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu Siong","family":"Ng","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London & Bart's Heart Centre, Bart's Health NHS Trust, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Shun-Shin","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London & Bart's Heart Centre, Bart's Health NHS Trust, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Koa-Wing","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London & Bart's Heart Centre, Bart's Health NHS Trust, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London & Bart's Heart Centre, Bart's Health NHS Trust, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary I","family":"Whinnett","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London & Bart's Heart Centre, Bart's Health NHS Trust, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick F","family":"Linton","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London & Bart's Heart Centre, Bart's Health NHS Trust, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Lefroy","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London & Bart's Heart Centre, Bart's Health NHS Trust, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darrel P","family":"Francis","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London & Bart's Heart Centre, Bart's Health NHS Trust, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sian E","family":"Harding","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London & Bart's Heart Centre, Bart's Health NHS Trust, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D Wyn","family":"Davies","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas S","family":"Peter","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London & Bart's Heart Centre, Bart's Health NHS Trust, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phang Boon","family":"Lim","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London & Bart's Heart Centre, Bart's Health NHS Trust, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elijah","family":"Behr","sequence":"additional","affiliation":[{"name":"St George\u2019s University Hospitals NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier D","family":"Lambiase","sequence":"additional","affiliation":[{"name":"Bart\u2019s Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Varnava","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London & Bart's Heart Centre, Bart's Health NHS Trust, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prapa","family":"Kanagaratnam","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London & Bart's Heart Centre, Bart's Health NHS Trust, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,10,21]]},"reference":[{"key":"2021020808555300300_euaa248-B1","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1161\/01.RES.14.1.44","article-title":"Nonuniform recovery of excitability in ventricular muscle","volume":"14","author":"Han","year":"1964","journal-title":"Circ Res"},{"key":"2021020808555300300_euaa248-B2","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.1152\/ajpheart.00355.2007","article-title":"Role of spatial dispersion of repolarization in inherited and acquired sudden cardiac death syndromes","volume":"293","author":"Antzelevitch","year":"2007","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2021020808555300300_euaa248-B3","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1093\/europace\/eup432","article-title":"Abnormal restitution property of action potential duration and conduction delay in Brugada syndrome: both repolarization and depolarization abnormalities","volume":"12","author":"Nishii","year":"2010","journal-title":"Europace"},{"key":"2021020808555300300_euaa248-B4","doi-asserted-by":"crossref","first-page":"2565","DOI":"10.1161\/01.CIR.92.9.2565","article-title":"Primary ventricular fibrillation is associated with increased paced right ventricular electrogram fractionation","volume":"92","author":"Saumarez","year":"1995","journal-title":"Circulation"},{"key":"2021020808555300300_euaa248-B5","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1161\/01.RES.84.11.1318","article-title":"Spatiotemporal heterogeneity in the induction of ventricular fibrillation by rapid pacing: importance of cardiac restitution properties","volume":"84","author":"Cao","year":"1999","journal-title":"Circ Res"},{"key":"2021020808555300300_euaa248-B6","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/j.cardiores.2006.12.001","article-title":"Autonomic modulation of electrical restitution, alternans and ventricular fibrillation initiation in the isolated heart","volume":"73","author":"Ng","year":"2007","journal-title":"Cardiovasc Res"},{"key":"2021020808555300300_euaa248-B7","first-page":"746","volume":"8","author":"Zipes"},{"key":"2021020808555300300_euaa248-B8","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1111\/jce.13375","article-title":"Repolarization abnormalities unmasked with exercise in sudden cardiac death survivors with structurally normal hearts","volume":"29","author":"Leong","year":"2018","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2021020808555300300_euaa248-B9","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euz015","article-title":"Ventricular conduction stability test: a method to identify and quantify changes in whole heart activation patterns during physiological stress","author":"Shun-Shin","year":"2019","journal-title":"Eurpace"},{"key":"2021020808555300300_euaa248-B10","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3","article-title":"Index for rating diagnostic tests","volume":"3","author":"Youden","year":"1950","journal-title":"Cancer"},{"key":"2021020808555300300_euaa248-B11","doi-asserted-by":"crossref","first-page":"2010","DOI":"10.1093\/eurheartj\/eht439","article-title":"A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM Risk-SCD)","volume":"35","author":"O'Mahony","year":"2014","journal-title":"Eur Heart J"},{"key":"2021020808555300300_euaa248-B12","doi-asserted-by":"crossref","first-page":"2733","DOI":"10.1093\/eurheartj\/ehu284","article-title":"2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC)","volume":"35","author":"Elliott","year":"2014","journal-title":"Eur Heart J"},{"key":"2021020808555300300_euaa248-B13","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1161\/hc3701.095952","article-title":"Hypertrophic cardiomyopathy: histopathological features of sudden death in cardiac troponin T disease","volume":"104","author":"Varnava","year":"2001","journal-title":"Circulation"},{"key":"2021020808555300300_euaa248-B14","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1161\/CIRCULATIONAHA.108.771401","article-title":"High-density substrate mapping in Brugada syndrome: combined role of conduction and repolarization heterogeneities in arrhythmogenesis","volume":"120","author":"Lambiase","year":"2009","journal-title":"Circulation"},{"key":"2021020808555300300_euaa248-B15","doi-asserted-by":"crossref","first-page":"1950","DOI":"10.1161\/CIRCULATIONAHA.114.013698","article-title":"Cardiac electrophysiological substrate underlying the ECG phenotype and electrogram abnormalities in Brugada syndrome patients","volume":"131","author":"Zhang","year":"2015","journal-title":"Circulation"},{"key":"2021020808555300300_euaa248-B16","doi-asserted-by":"crossref","first-page":"2022","DOI":"10.1136\/hrt.2009.174052","article-title":"Unmasking of the Brugada phenotype during exercise testing and its association with ventricular arrhythmia on the recovery phase","volume":"95","author":"Papadakis","year":"2009","journal-title":"Heart"},{"key":"2021020808555300300_euaa248-B17","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1016\/S0735-1097(99)00056-X","article-title":"Survival after cardiac arrest or sustained ventricular tachycardia in patients with hypertrophic cardiomyopathy","volume":"33","author":"Elliott","year":"1999","journal-title":"J Am Coll Cardiol"},{"key":"2021020808555300300_euaa248-B18","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1016\/j.jacc.2010.06.033","article-title":"Augmented ST-segment elevation during recovery from exercise predicts cardiac events in patients with Brugada syndrome","volume":"56","author":"Makimoto","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2021020808555300300_euaa248-B19","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1111\/jce.13194","article-title":"Ventricular tachyarrhythmias in patients with hypertrophic cardiomyopathy and defibrillators: triggers, treatment, and implications","volume":"28","author":"Link","year":"2017","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2021020808555300300_euaa248-B20","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1016\/S0735-1097(98)00120-X","article-title":"Electrocardiographic identification of abnormal ventricular depolarization and repolarization in patients with idiopathic ventricular fibrillation","volume":"31","author":"Peeters","year":"1998","journal-title":"J Am Coll Cardiol"}],"container-title":["EP Europace"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/europace\/article-pdf\/23\/2\/305\/36209333\/euaa248.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/europace\/article-pdf\/23\/2\/305\/36209333\/euaa248.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T19:32:51Z","timestamp":1612812771000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/23\/2\/305\/5934079"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,21]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,10,21]]},"published-print":{"date-parts":[[2021,2,5]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euaa248","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,2,1]]},"published":{"date-parts":[[2020,10,21]]}}}