{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:39:08Z","timestamp":1792525148159,"version":"4.5.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Ventricular fibrillation (VF) remains a leading cause of sudden cardiac death with an incompletely characterized electrophysiological substrate. Traditional large-animal VF models are limited by hemodynamic collapse and myocardial ischemia. This study establishes a reproducible swine model using dual mechanical circulatory devices to enable high-density electroanatomic mapping under nonischemic conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Five Yorkshire swine (55\u201365 kg) underwent sustained VF supported by venoarterial extracorporeal membrane oxygenation (2.5\u20133.0 L\/min) and percutaneous left ventricular unloading (Impella CP, P-2\u2013P-4). High-density electroanatomic mapping using CARTO 7 was performed at baseline and after defibrillation. Bipolar voltage was acquired from 7 predefined ventricular regions (21 measurements per animal per time point; n=210 paired observations). Unipolar voltage mapping and continuous surface ECG monitoring were used to assess acute ischemic injury. Systemic perfusion was maintained at systolic arterial pressure \u226580 mm\u2009Hg. Linear mixed-effects modeling was used to analyze voltage changes from pre-VF to post-VF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Sustained VF (10\u00b11 minutes) was reproducibly induced and maintained with consistent hemodynamics (systolic arterial pressure, 90\u00b15 mm\u2009Hg; extracorporeal membrane oxygenation flow, 2.5\u00b10.5 L\/min). All animals were successfully defibrillated. High-density mapping was feasible in all experiments (1000\u00b1300 points per chamber). Bipolar voltage showed no change from pre-VF (5.86\u00b12.56 mV) to post-VF (6.53\u00b12.22 mV; mean difference, 0.67 mV [95% CI, \u20130.31 to 1.65];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.15). Both left (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.17) and right ventricles (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.08) demonstrated voltage preservation. Regional analysis showed no significant changes (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt;0.05); post-VF voltages remained above viability thresholds (&gt;1.5 mV). Unipolar voltage maps recovered toward baseline, with no ECG injury pattern identified after defibrillation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Dual mechanical circulatory support with venoarterial extracorporeal membrane oxygenation and Impella CP enables reproducible, high-fidelity electroanatomic mapping and preserves myocardial substrate after sustained VF in a large-animal model. This platform overcomes key technical barriers in VF research, providing a nonischemic foundation for future mechanistic and translational studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.126.014954","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:06:40Z","timestamp":1789722400000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Ventricular Fibrillation Mapping in a Large-Animal Model Using Dual Mechanical Circulatory Support: Electroanatomic Substrate Preservation Without Ischemic Changes"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9307-779X","authenticated-orcid":true,"given":"Karol","family":"Quelal Analuisa","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester (K.Q.A., J.A.T., I.U.H., A.A.W., H.N., A.B., S.M.Y., R.C.W., F.M.E., E.G.T., N.Y.T., F.D.-C.M., S.J.A., C.V.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6963-8924","authenticated-orcid":true,"given":"Jason A.","family":"Tri","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester (K.Q.A., J.A.T., I.U.H., A.A.W., H.N., A.B., S.M.Y., R.C.W., F.M.E., E.G.T., N.Y.T., F.D.-C.M., S.J.A., C.V.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3574-5814","authenticated-orcid":true,"given":"Ikram U.","family":"Haq","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester (K.Q.A., J.A.T., I.U.H., A.A.W., H.N., A.B., S.M.Y., R.C.W., F.M.E., E.G.T., N.Y.T., F.D.-C.M., S.J.A., C.V.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1631-9665","authenticated-orcid":true,"given":"Amalia A.","family":"Welle","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester (K.Q.A., J.A.T., I.U.H., A.A.W., H.N., A.B., S.M.Y., R.C.W., F.M.E., E.G.T., N.Y.T., F.D.-C.M., S.J.A., C.V.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanxu","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester (K.Q.A., J.A.T., I.U.H., A.A.W., H.N., A.B., S.M.Y., R.C.W., F.M.E., E.G.T., N.Y.T., F.D.-C.M., S.J.A., C.V.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3775-5784","authenticated-orcid":true,"given":"Atta","family":"Behfar","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester (K.Q.A., J.A.T., I.U.H., A.A.W., H.N., A.B., S.M.Y., R.C.W., F.M.E., E.G.T., N.Y.T., F.D.-C.M., S.J.A., C.V.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suraj M.","family":"Yalamuri","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester (K.Q.A., J.A.T., I.U.H., A.A.W., H.N., A.B., S.M.Y., R.C.W., F.M.E., E.G.T., N.Y.T., F.D.-C.M., S.J.A., C.V.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8115-413X","authenticated-orcid":true,"given":"Robert C.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester (K.Q.A., J.A.T., I.U.H., A.A.W., H.N., A.B., S.M.Y., R.C.W., F.M.E., E.G.T., N.Y.T., F.D.-C.M., S.J.A., C.V.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6204-4557","authenticated-orcid":true,"given":"Fatima M.","family":"Ezzeddine","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester (K.Q.A., J.A.T., I.U.H., A.A.W., H.N., A.B., S.M.Y., R.C.W., F.M.E., E.G.T., N.Y.T., F.D.-C.M., S.J.A., C.V.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1624-5793","authenticated-orcid":true,"given":"Elena G.","family":"Tolkacheva","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester (K.Q.A., J.A.T., I.U.H., A.A.W., H.N., A.B., S.M.Y., R.C.W., F.M.E., E.G.T., N.Y.T., F.D.-C.M., S.J.A., C.V.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0365-9471","authenticated-orcid":true,"given":"Nicholas Y.","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester (K.Q.A., J.A.T., I.U.H., A.A.W., H.N., A.B., S.M.Y., R.C.W., F.M.E., E.G.T., N.Y.T., F.D.-C.M., S.J.A., C.V.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9511-1245","authenticated-orcid":true,"given":"Freddy","family":"Del-Carpio Munoz","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester (K.Q.A., J.A.T., I.U.H., A.A.W., H.N., A.B., S.M.Y., R.C.W., F.M.E., E.G.T., N.Y.T., F.D.-C.M., S.J.A., C.V.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9835-5536","authenticated-orcid":true,"given":"Samuel J.","family":"Asirvatham","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester (K.Q.A., J.A.T., I.U.H., A.A.W., H.N., A.B., S.M.Y., R.C.W., F.M.E., E.G.T., N.Y.T., F.D.-C.M., S.J.A., C.V.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8420-4670","authenticated-orcid":true,"given":"Christopher V.","family":"DeSimone","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester (K.Q.A., J.A.T., I.U.H., A.A.W., H.N., A.B., S.M.Y., R.C.W., F.M.E., E.G.T., N.Y.T., F.D.-C.M., S.J.A., 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