{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T17:18:59Z","timestamp":1773940739545,"version":"3.50.1"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Catheter ablation of ventricular tachycardia (VT) in structural heart disease is challenging because of noninducibility or hemodynamic compromise. Ablation often depends on elimination of local abnormal ventricular activities (LAVAs) but which may be hidden in far-field signal. We investigated whether altering activation wavefront affects activation timing and LAVA characterization and allows a better understanding of isthmus anatomy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Patients with ischemic cardiomyopathy underwent mapping using the ultra-high density Rhythmia system (Boston Scientific). Maps were generated for all stable VTs and with pacing from the atrium, right ventricular apex, and an left ventricular branch of the coronary sinus.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Fifty-six paced maps and 23 VT circuits were mapped in 22 patients. In 79% of activation maps, there was \u22651 line of block in the paced conduction wavefront, with 93% having fixed block and 32% showing functional partial block. Bipolar scar was larger with atrial than right ventricular (31.7\u00b118.5 versus 27.6\u00b116.3 cm\n              <jats:sup>2<\/jats:sup>\n              ,\n              <jats:italic>P<\/jats:italic>\n              =0.003) or left ventricular pacing (31.7\u00b118.5 versus 27.0\u00b119.2 cm\n              <jats:sup>2<\/jats:sup>\n              ,\n              <jats:italic>P<\/jats:italic>\n              =0.009); LAVA areas were smaller with atrial than right ventricular (12.3\u00b110.5 versus 18.4\u00b111.0 cm\n              <jats:sup>2<\/jats:sup>\n              ,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) or left ventricular pacing (12.3\u00b110.5 versus 17.1\u00b110.7 cm\n              <jats:sup>2<\/jats:sup>\n              ,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). LAVA areas were larger with wavefront propagation perpendicular versus parallel to the line of block along isthmus boundaries (19.3\u00b17.1 versus 13.6\u00b17.4 cm\n              <jats:sup>2<\/jats:sup>\n              ,\n              <jats:italic>P<\/jats:italic>\n              =0.01). All patients had successful VT isthmus ablation. In 11\u00b18 months follow-up, 2 patients had a recurrence.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Wavefronts of conduction slowing\/block may aid identification of critical isthmuses in unmappable VTs. Altering the activation wavefront leads to significant differences in conduction properties of myocardial tissue, along with scar and LAVA characterization. In patients where few LAVAs are identified during substrate mapping, using an alternate activation wavefront running perpendicular to the VT isthmus may increase sensitivity to detect arrhythmogenic substrate and critical sites for reentry.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.119.007293","type":"journal-article","created":{"date-parts":[[2019,5,24]],"date-time":"2019-05-24T09:00:24Z","timestamp":1558688424000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["Effect of Activation Wavefront on Electrogram Characteristics During Ventricular Tachycardia Ablation"],"prefix":"10.1161","volume":"12","author":[{"given":"Claire A.","family":"Martin","sequence":"first","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."},{"name":"Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (C.A.M., P.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruairidh","family":"Martin","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."},{"name":"Newcastle University, United Kingdom (R.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Maury","sequence":"additional","affiliation":[{"name":"Toulouse University Hospital, France (P.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Meyer","sequence":"additional","affiliation":[{"name":"University Medical Center Hamburg\u2013Eppendorf, Germany (C.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Wong","sequence":"additional","affiliation":[{"name":"Brompton Hospital, London, United Kingdom (T.W., R.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corentin","family":"Dallet","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Shi","sequence":"additional","affiliation":[{"name":"Brompton Hospital, London, United Kingdom (T.W., R.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parag","family":"Gajendragadkar","sequence":"additional","affiliation":[{"name":"Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (C.A.M., P.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masateru","family":"Takigawa","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Frontera","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghassen","family":"Cheniti","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathaniel","family":"Thompson","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Kitamura","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Vlachos","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Wolf","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Bourier","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Lam","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josselin","family":"Duch\u00e2teau","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gr\u00e9goire","family":"Massoulli\u00e9","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Pambrun","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnaud","family":"Denis","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Derval","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R\u00e9mi","family":"Dubois","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00e9l\u00e8ze","family":"Hocini","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Ha\u00efssaguerre","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Ja\u00efs","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. Ha\u00efssaguerre, P.J., F.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Sacher","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9, F-\/Bordeaux University Hospital (CHU), Electrophysiology and Ablation Unit, University of Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, France\/Pessac\u2013Bordeaux, France (C.A.M., R.M., C.D., M.T., A.F., G.C., N.T., T.K., K.V., M.W., F.B., A.L., J.D., G.M., T.P., A.D., N.D., R.D., M. Hocini, M. 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