{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T17:07:55Z","timestamp":1765040875313,"version":"3.37.3"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,3,1]],"date-time":"2019-03-01T00:00:00Z","timestamp":1551398400000},"content-version":"vor","delay-in-days":1,"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":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Abnormal rate adaptation of the action potential is proarrhythmic but is difficult to measure with current electro-anatomical mapping techniques. We developed a method to rapidly quantify spatial discordance in whole heart activation in response to rate cycle length changes. We test the hypothesis that patients with underlying channelopathies or history of aborted sudden cardiac death (SCD) have a reduced capacity to maintain uniform activation following exercise.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Electrocardiographical imaging (ECGI) reconstructs &gt;1200 electrograms (EGMs) over the ventricles from a single beat, providing epicardial whole heart activation maps. Thirty-one individuals [11 SCD survivors; 10 Brugada syndrome (BrS) without SCD; and 10 controls] with structurally normal hearts underwent ECGI vest recordings following exercise treadmill. For each patient, we calculated the relative change in EGM local activation times (LATs) between a baseline and post-exertion phase using custom written software. A ventricular conduction stability (V-CoS) score calculated to indicate the percentage of ventricle that showed no significant change in relative LAT (&lt;10\u2009ms). A lower score reflected greater conduction heterogeneity. Mean variability (standard deviation) of V-CoS score over 10 consecutive beats was small (0.9\u2009\u00b1\u20090.5%), with good inter-operator reproducibility of V-CoS scores. Sudden cardiac death survivors, compared to BrS and controls, had the lowest V-CoS scores post-exertion (P\u2009=\u20090.011) but were no different at baseline (P\u2009=\u20090.50).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>We present a method to rapidly quantify changes in global activation which provides a measure of conduction heterogeneity and proof of concept by demonstrating SCD survivors have a reduced capacity to maintain uniform activation following exercise.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euz015","type":"journal-article","created":{"date-parts":[[2019,2,2]],"date-time":"2019-02-02T15:08:47Z","timestamp":1549120127000},"page":"1422-1431","source":"Crossref","is-referenced-by-count":5,"title":["Ventricular conduction stability test: a method to identify and quantify changes in whole heart activation patterns during physiological stress"],"prefix":"10.1093","volume":"21","author":[{"given":"Matthew J","family":"Shun-Shin","sequence":"first","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London, London, UK"},{"name":"Imperial College Healthcare NHS Trust, Du Cane Road, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin M W","family":"Leong","sequence":"additional","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London, London, UK"},{"name":"Imperial College Healthcare NHS Trust, Du Cane Road, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fu Siong","family":"Ng","sequence":"additional","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London, London, UK"},{"name":"Imperial College Healthcare NHS Trust, Du Cane Road, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas W F","family":"Linton","sequence":"additional","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London, London, UK"},{"name":"Imperial College Healthcare NHS Trust, Du Cane Road, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary I","family":"Whinnett","sequence":"additional","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London, London, UK"},{"name":"Imperial College Healthcare NHS Trust, Du Cane Road, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Koa-Wing","sequence":"additional","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London, London, UK"},{"name":"Imperial College Healthcare NHS Trust, Du Cane Road, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norman","family":"Qureshi","sequence":"additional","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London, London, UK"},{"name":"Imperial College Healthcare NHS Trust, Du Cane Road, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David C","family":"Lefroy","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, Du Cane Road, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sian E","family":"Harding","sequence":"additional","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phang Boon","family":"Lim","sequence":"additional","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London, London, UK"},{"name":"Imperial College Healthcare NHS Trust, Du Cane Road, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas S","family":"Peters","sequence":"additional","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London, London, UK"},{"name":"Imperial College Healthcare NHS Trust, Du Cane Road, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darrel P","family":"Francis","sequence":"additional","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London, London, UK"},{"name":"Imperial College Healthcare NHS Trust, Du Cane Road, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda M","family":"Varnava","sequence":"additional","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London, London, UK"},{"name":"Imperial College Healthcare NHS Trust, Du Cane Road, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prapa","family":"Kanagaratnam","sequence":"additional","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London, London, UK"},{"name":"Imperial College Healthcare NHS Trust, Du Cane Road, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,2,28]]},"reference":[{"key":"2019091011541582500_euz015-B1","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1161\/01.RES.53.6.815","article-title":"Electrical and mechanical restitution of the human heart at different rates of stimulation","volume":"53","author":"Franz","year":"1983","journal-title":"Circ Res"},{"key":"2019091011541582500_euz015-B2","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1172\/JCI113706","article-title":"Cycle length dependence of human action potential duration in vivo and different steady-state frequencies","volume":"82","author":"Franz","year":"1988","journal-title":"J Clin Invest"},{"key":"2019091011541582500_euz015-B3","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1161\/01.CIR.95.6.1611","article-title":"A novel method for nonfluoroscopic catheter-based electroanatomical mapping of the heart in vitro and in vivo accuracy results","volume":"95","author":"Gepstein","year":"1997","journal-title":". Circulation"},{"key":"2019091011541582500_euz015-B4","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1093\/europace\/eul079","article-title":"Electrical isolation of pulmonary veins in patients with atrial fibrillation: reduction of fluoroscopy exposure and procedure duration by the use of a non-fluoroscopic navigation system (NAVX)","volume":"8","author":"Estner","year":"2006","journal-title":"Europace"},{"key":"2019091011541582500_euz015-B5","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1161\/CIRCEP.111.968602","article-title":"Rapid high resolution electroanatomical mapping: evaluation of a new system in a canine atrial linear lesion model","volume":"5","author":"Nakagawa","year":"2012","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2019091011541582500_euz015-B6","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1161\/01.CIR.100.16.1744","article-title":"Electroanatomic left ventricular mapping in the porcine model of healed anterior myocardial infarction: correlation with intracardiac echocardiography and pathological analysis","volume":"100","author":"Callans","year":"1999","journal-title":"Circulation"},{"key":"2019091011541582500_euz015-B7","doi-asserted-by":"crossref","first-page":"2044","DOI":"10.1016\/j.jacc.2003.12.054","article-title":"A new approach for catheter ablation of atrial fibrillation: mapping of the electrophysiologic substrate","volume":"43","author":"Nademanee","year":"2004","journal-title":"J Am Coll Cardiol"},{"key":"2019091011541582500_euz015-B8","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1038\/nm1011","article-title":"Noninvasive electrocardiographic imaging for cardiac electrophysiology and arrhythmia","volume":"10","author":"Ramanathan","year":"2004","journal-title":"Nat Med"},{"key":"2019091011541582500_euz015-B9","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1161\/CIRCRESAHA.112.279315","article-title":"Noninvasive electrocardiographic imaging of arrhythmogenic substrates in humans","volume":"112","author":"Rudy","year":"2013","journal-title":"Circ Res"},{"key":"2019091011541582500_euz015-B10","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1161\/hc3601.094277","article-title":"Imaging dispersion of myocardial repolarization, II: noninvasive reconstruction of epicardial measures","volume":"104","author":"Ghanem","year":"2001","journal-title":"Circulation"},{"key":"2019091011541582500_euz015-B11","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.hrthm.2014.01.013","article-title":"Noninvasive electrocardiographic mapping to guide ablation of outflow tract ventricular arrhythmias","volume":"11","author":"Jamil-Copley","year":"2014","journal-title":"Heart Rhythm"},{"volume-title":"Flattening the Earth: Two Thousand Years of Map Projections","year":"1997","author":"Snyder","key":"2019091011541582500_euz015-B12"},{"key":"2019091011541582500_euz015-B13","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":"2019091011541582500_euz015-B14","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":"2019091011541582500_euz015-B15","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1093\/europace\/eut272","article-title":"Executive summary: HRS\/EHRA\/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes","volume":"15","author":"Priori","year":"2013","journal-title":"Europace"},{"key":"2019091011541582500_euz015-B16","doi-asserted-by":"crossref","DOI":"10.1007\/978-0-387-98141-3","volume-title":"ggplot2: Elegant Graphics for Data Analysis","author":"Wickham","year":"2009"},{"key":"2019091011541582500_euz015-B17","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1161\/01.CIR.41.6.899","article-title":"Total excitation of the isolated human heart","volume":"41","author":"Durrer","year":"1970","journal-title":"Circulation"},{"key":"2019091011541582500_euz015-B18","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":"2019091011541582500_euz015-B19","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"},{"key":"2019091011541582500_euz015-B20","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/S0008-6363(01)00197-3","article-title":"Dispersion of ventricular repolarization and refractory period","volume":"50","author":"Burton","year":"2001","journal-title":"Cardiovasc Res"},{"key":"2019091011541582500_euz015-B21","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":"2019091011541582500_euz015-B22","doi-asserted-by":"crossref","first-page":"1936","DOI":"10.1161\/CIRCULATIONAHA.114.011359","article-title":"Electrophysiologic substrate in congenital long QT syndrome: noninvasive mapping with electrocardiographic imaging (ECGI)","volume":"130","author":"Vijayakumar","year":"2014","journal-title":"Circulation"}],"container-title":["EP Europace"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/europace\/article-pdf\/21\/9\/1422\/29581822\/euz015.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T04:43:09Z","timestamp":1568954589000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/21\/9\/1422\/5366944"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,28]]},"references-count":22,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,2,28]]},"published-print":{"date-parts":[[2019,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euz015","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"type":"print","value":"1099-5129"},{"type":"electronic","value":"1532-2092"}],"subject":[],"published-other":{"date-parts":[[2019,9]]},"published":{"date-parts":[[2019,2,28]]}}}