{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T21:36:26Z","timestamp":1786311386254,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>High density electroanatomical mapping (EAM) is the standard for identifying functional substrate in scar\u2010related ventricular tachycardia (VT), but it is limited by its two\u2010dimensional nature and increased procedural complexity. Imaging\u2010based strategies provide anatomical characterization but lack functional information. We evaluated a novel digital twin model (CardioMat) to non\u2010invasively predict functional substrate in three\u2010dimensions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To validate a novel digital twin model for noninvasive prediction of functional substrate in scar\u2010related ventricular tachycardia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifteen patients with ischemic or nonischemic cardiomyopathy undergoing VT ablation were retrospectively analyzed. High\u2010density EAM, cardiac magnetic resonance (CMR) post\u2010processing with ADAS3D, and CardioMat modeling were performed. CardioMat\u2010generated three\u2010dimensional activation maps were integrated into the CARTO EAM suite. Deceleration zones (DZs) identified by CardioMat were compared with EAM\u2010derived DZs and CMR\u2010based heterogeneous tissue channels (HTCs) and scar areas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 255 cardiac segments were analyzed. CardioMat\u2010derived DZs demonstrated high diagnostic accuracy (79% sensitivity, 93% specificity, 81% PPV, 92% NPV, 89% accuracy) for predicting EAM\u2010DZ localization, outperforming CMR scar and HTCs. Multivariate analysis confirmed CardioMat DZs are the strongest independent predictor of EAM\u2010DZ localization (OR 17.4, 95% CI 6.9\u201343.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides preliminary evidence supporting the feasibility of a digital twin model for noninvasive functional substrate characterization. CardioMat integrates anatomical and functional information, outperforming conventional CMR\u2010based assessment. Prospective multicenter validation is needed to establish its role in VT ablation guidance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70184","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T07:25:18Z","timestamp":1763537118000},"page":"102-109","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Validation of a Digital Twin Model for Three\u2010Dimensional Noninvasive Functional Substrate Prediction in Scar Related Ventricular Tachycardia"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9397-1938","authenticated-orcid":false,"given":"Matteo","family":"Parollo","sequence":"first","affiliation":[{"name":"Second Division of Cardiology, Cardiothoracic and Vascular Department Pisa University Hospital Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niccol\u00f2","family":"Biasi","sequence":"additional","affiliation":[{"name":"Information Engineering Department University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Torre","sequence":"additional","affiliation":[{"name":"Second Division of Cardiology, Cardiothoracic and Vascular Department Pisa University Hospital Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8146-109X","authenticated-orcid":false,"given":"Lorenzo","family":"Pistelli","sequence":"additional","affiliation":[{"name":"Second Division of Cardiology, Cardiothoracic and Vascular Department Pisa University Hospital Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Fiorentini","sequence":"additional","affiliation":[{"name":"Second Division of Cardiology, Cardiothoracic and Vascular Department Pisa University Hospital Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario Giannotti","family":"Santoro","sequence":"additional","affiliation":[{"name":"Second Division of Cardiology, Cardiothoracic and Vascular Department Pisa University Hospital Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Canu","sequence":"additional","affiliation":[{"name":"Second Division of Cardiology, Cardiothoracic and Vascular Department Pisa University Hospital Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"De Lucia","sequence":"additional","affiliation":[{"name":"Second Division of Cardiology, Cardiothoracic and Vascular Department Pisa University Hospital Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gino","family":"Grifoni","sequence":"additional","affiliation":[{"name":"Second Division of Cardiology, Cardiothoracic and Vascular Department Pisa University Hospital Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3083-7376","authenticated-orcid":false,"given":"Andrea","family":"Di Cori","sequence":"additional","affiliation":[{"name":"Second Division of Cardiology, Cardiothoracic and Vascular Department Pisa University Hospital Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1421-9033","authenticated-orcid":false,"given":"Luca","family":"Segreti","sequence":"additional","affiliation":[{"name":"Second Division of Cardiology, Cardiothoracic and Vascular Department Pisa University Hospital Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Tognetti","sequence":"additional","affiliation":[{"name":"Information Engineering Department University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7274-4541","authenticated-orcid":false,"given":"Giulio","family":"Zucchelli","sequence":"additional","affiliation":[{"name":"Second Division of Cardiology, Cardiothoracic and Vascular Department Pisa University Hospital Pisa 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