{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T19:14:08Z","timestamp":1758395648630,"version":"3.37.3"},"reference-count":18,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,9,22]],"date-time":"2019-09-22T00:00:00Z","timestamp":1569110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Electronatomical mapping allows direct and accurate visualization of myocardial abnormalities. This study investigated whether high\u2010density endocardial bipolar voltage mapping of the right ventricular outflow tract (RVOT) during sinus rhythm may guide catheter ablation of idiopathic ventricular arrhythmias (VAs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Forty\u2010four patients (18 males, mean age: 38.1\u2009\u00b1\u200913.8 years) with idiopathic RVOT VAs and negative cardiac magnetic resonance imaging underwent a stepwise mapping approach for the identification of the site of origin (SOO). High\u2010density electronatomical mapping (1096.6\u2009\u00b1\u2009322.3 points) was performed during sinus rhythm and identified at least two low bipolar voltage areas less than 1\u2009mV (mean amplitude of 0.20\u2009\u00b1\u20090.10\u2009mV) in 39 of 44 patients. The mean low\u2010voltage surface area was 1.4\u2009\u00b1\u20090.8\u2009cm<jats:sup>2<\/jats:sup>. Group 1 consisted of 28 patients exhibiting low\u2010voltage areas and high\u2010arrhythmia burden during the procedure. Pace match to the clinical VAs was produced in one of these low\u2010voltage areas. Activation mapping established the SOO at these sites in 27 of 28 cases. Group 2 comprised 11 patients exhibiting abnormal electroanatomical mapping, but very low\u2010arrhythmia burden during the procedure. Pace mapping produced a near\u2010perfect or perfect match to the clinical VAs in one of these areas in 9 of 11 patients which was marked as potential SOO and targeted for ablation. During the follow\u2010up period, 25 of 28 patients from group 1 (89%) and 7 of 9 patients from group 2 (78%) were free from VAs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Small but detectable very low\u2010voltage areas during mapping in sinus rhythm characterize the arrhythmogenic substrate of idiopathic RVOT VAs and may guide successful catheter ablation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14155","type":"journal-article","created":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T04:10:02Z","timestamp":1568088602000},"page":"2362-2369","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Right ventricular outflow tract low\u2010voltage areas identify the site of origin of idiopathic ventricular arrhythmias: A high\u2010density mapping study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8924-8261","authenticated-orcid":false,"given":"Konstantinos P.","family":"Letsas","sequence":"first","affiliation":[{"name":"Second Department of Cardiology, Laboratory of Cardiac Electrophysiology \u201cEvangelismos\u201d General Hospital of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Efremidis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Laboratory of Cardiac Electrophysiology \u201cEvangelismos\u201d General Hospital of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Vlachos","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Laboratory of Cardiac Electrophysiology \u201cEvangelismos\u201d General Hospital of Athens  Athens Greece"},{"name":"H\u00f4pital Cardiologique du Haut\u2010L\u00e9v\u00eaque, CHU Bordeaux, L'Institut de RYthmologie et mod\u00e9lisation Cardiaque (LIRYC) Universit\u00e9 Bordeaux  Bordeaux France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8024-8983","authenticated-orcid":false,"given":"Dimitrios","family":"Asvestas","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Laboratory of Cardiac Electrophysiology \u201cEvangelismos\u201d General Hospital of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8473-7514","authenticated-orcid":false,"given":"Masateru","family":"Takigawa","sequence":"additional","affiliation":[{"name":"H\u00f4pital Cardiologique du Haut\u2010L\u00e9v\u00eaque, CHU Bordeaux, L'Institut de RYthmologie et mod\u00e9lisation Cardiaque (LIRYC) Universit\u00e9 Bordeaux  Bordeaux France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1009-9772","authenticated-orcid":false,"given":"George","family":"Bazoukis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Laboratory of Cardiac Electrophysiology \u201cEvangelismos\u201d General Hospital of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0372-4480","authenticated-orcid":false,"given":"Antonio","family":"Frontera","sequence":"additional","affiliation":[{"name":"H\u00f4pital Cardiologique du Haut\u2010L\u00e9v\u00eaque, CHU Bordeaux, L'Institut de RYthmologie et mod\u00e9lisation Cardiaque (LIRYC) Universit\u00e9 Bordeaux  Bordeaux France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7287-3850","authenticated-orcid":false,"given":"George","family":"Giannopoulos","sequence":"additional","affiliation":[{"name":"Department of Cardiology \u201cG. Gennimatas\u201d General Hospital of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Athanasios","family":"Saplaouras","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Laboratory of Cardiac Electrophysiology \u201cEvangelismos\u201d General Hospital of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antigoni","family":"Sakellaropoulou","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Laboratory of Cardiac Electrophysiology \u201cEvangelismos\u201d General Hospital of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panagiotis","family":"Mililis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Laboratory of Cardiac Electrophysiology \u201cEvangelismos\u201d General Hospital of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stylianos","family":"Dragasis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Laboratory of Cardiac Electrophysiology \u201cEvangelismos\u201d General Hospital of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Athanasia","family":"Megarisiotou","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Laboratory of Cardiac Electrophysiology \u201cEvangelismos\u201d General Hospital of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kosmas","family":"Valkanas","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Laboratory of Cardiac Electrophysiology \u201cEvangelismos\u201d General Hospital of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5510-1253","authenticated-orcid":false,"given":"Gary","family":"Tse","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Faculty of Medicine Chinese University of Hong Kong  Hong Kong, SAR China"},{"name":"Li Ka Shing Institute of Health Sciences, Faculty of Medicine Chinese University of Hong Kong  Hong Kong, SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0482-0738","authenticated-orcid":false,"given":"Tong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tianjin Institute of Cardiology Second Hospital of Tianjin Medical University  Tianjin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Spyridon","family":"Deftereos","sequence":"additional","affiliation":[{"name":"Department of Cardiology \u201cG. 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