{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:06:41Z","timestamp":1789722401645,"version":"4.0.1"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2021,1,19]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Fast ventricular tachycardias (VTs) have historically been attributed to shorter path lengths with smaller reentrant circuit dimensions in animal models. The relationship between the dimensions of the reentrant VT circuit and tachycardia cycle length (TCL) has not been examined in humans. This study aimed to analyze the determinants of the rate of human VT with comparison of circuit dimensions and conduction velocity (CV) across a wide range of both stable and unstable VTs delineated by high-resolution mapping.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Fifty-four VTs with complete circuit delineation (&gt;90% TCL) by high-resolution multielectrode mapping were analyzed in 49 patients (men, 88%; age, 65 years [58\u201371 years]; nonischemic, 47%). Fast VT was defined as TCL &lt;333 milliseconds (rate &gt;180 bpm). Unstable VT was defined by hemodynamic deterioration with an intrinsic mean arterial pressure &lt;60 mm\u2009Hg during a sustained episode.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              The median TCL of VT was 365 milliseconds (306\u2013443 milliseconds), and 24 fast VTs were characterized. A wide range of CVs was observed within the entrance (0.03\u20130.55 m\/s), common pathway (0.03\u20130.77 m\/s), exit (0.03\u20130.53 m\/s), and outer loop (0.17\u20131.13 m\/s). There were no significant differences in the median dimensions of the isthmus and path length between fast and slow VTs and between unstable and stable VTs. The outer loop CV was the only circuit component that correlated with TCL in both ischemic cardiomyopathy (\n              <jats:italic>r<\/jats:italic>\n              =\u22120.5,\n              <jats:italic>P<\/jats:italic>\n              =0.006) and nonischemic cardiomyopathy (\n              <jats:italic>r<\/jats:italic>\n              =\u22120.45,\n              <jats:italic>P<\/jats:italic>\n              =0.028). The duration of the longest diastolic electrogram was inversely correlated with the dimensions of common pathway (length:\n              <jats:italic>r<\/jats:italic>\n              =\u22120.46,\n              <jats:italic>P<\/jats:italic>\n              =0.001, width:\n              <jats:italic>r<\/jats:italic>\n              =\u22120.3,\n              <jats:italic>P<\/jats:italic>\n              =0.047) and predictive of rapid VT termination by a single radiofrequency application (\n              <jats:italic>r<\/jats:italic>\n              =\u22120.41,\n              <jats:italic>P<\/jats:italic>\n              =0.023).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Because of a wide spectrum of CV observed within the reentrant path during human VT, the dimensions of the circuit were not predictive of VT cycle length. For the first time, we demonstrate that the CV of the outer loop, rather than isthmus, is the principal determinant of the rate of VT. The size of the circuit was similar between fast and slow VTs and between unstable and stable VTs. Long, continuous electrograms were indicative of spatially confined isthmus dimensions, confirmed by rapid termination of VT during radiofrequency delivery.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.120.050363","type":"journal-article","created":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T10:02:01Z","timestamp":1605002521000},"page":"212-226","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":49,"title":["Circuit Determinants of Ventricular Tachycardia Cycle Length"],"prefix":"10.1161","volume":"143","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0234-390X","authenticated-orcid":true,"given":"Takuro","family":"Nishimura","sequence":"first","affiliation":[{"name":"The University of Chicago Medicine, Center for Arrhythmia Care, Pritzker School of Medicine, Department of Medicine, Section of Cardiology, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav A.","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"The University of Chicago Medicine, Center for Arrhythmia Care, Pritzker School of Medicine, Department of Medicine, Section of Cardiology, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaid A.","family":"Aziz","sequence":"additional","affiliation":[{"name":"The University of Chicago Medicine, Center for Arrhythmia Care, Pritzker School of Medicine, Department of Medicine, Section of Cardiology, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7624-742X","authenticated-orcid":true,"given":"Andrew D.","family":"Beaser","sequence":"additional","affiliation":[{"name":"The University of Chicago Medicine, Center for Arrhythmia Care, Pritzker School of Medicine, Department of Medicine, Section of Cardiology, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8032-4424","authenticated-orcid":true,"given":"Dalise Y.","family":"Shatz","sequence":"additional","affiliation":[{"name":"The University of Chicago Medicine, Center for Arrhythmia Care, Pritzker School of Medicine, Department of Medicine, Section of Cardiology, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemal M.","family":"Nayak","sequence":"additional","affiliation":[{"name":"The University of Chicago Medicine, Center for Arrhythmia Care, Pritzker School of Medicine, Department of Medicine, Section of Cardiology, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8513-1303","authenticated-orcid":true,"given":"Roderick","family":"Tung","sequence":"additional","affiliation":[{"name":"The University of Chicago Medicine, Center for Arrhythmia Care, Pritzker School of Medicine, Department of Medicine, Section of Cardiology, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/hc4101.097117"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.119.007879"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.12.044"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.042423"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.101.11.1288"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.891242"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.88.4.1647"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.10.042"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.05.011"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3495(96)79691-1"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.021955"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.118.006569"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.110.959213"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(88)90211-2"},{"key":"e_1_3_5_16_2","first-page":"158","article-title":"Identifying sites for catheter ablation of ventricular tachycardia.","volume":"17","author":"Stevenson WG","year":"1992","unstructured":"Stevenson, WG, Sager, P, Nademanee, K, Hassan, H, Middlekauff, HR, Saxon, LA, Wiener, I. 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