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ajpheart.00225.2019.pdf
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Description:
Final Accepted Manuscript
Author
Chinyere, Ikeotunye RoyalHutchinson, Mathew
Moukabary, Talal
Lancaster, Jordan
Goldman, Steven
Juneman, Elizabeth
Affiliation
Univ Arizona, Sarver Heart CtrUniv Arizona, Coll Med
Issue Date
2019-10-01
Metadata
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AMER PHYSIOLOGICAL SOCCitation
Chinyere, I. R., Hutchinson, M., Moukabary, T., Lancaster, J., Goldman, S., & Juneman, E. (2019). Monophasic action potential amplitude for substrate mapping. American Journal of Physiology-Heart and Circulatory Physiology, 317(4), H667-H673.Rights
Copyright © 2019 the American Physiological Society.Collection Information
This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.Abstract
Although radiofrequency ablation has revolutionized the management of tachyarrhythmias, the rate of arrhythmia recurrence is a large drawback. Successful substrate identification is paramount to abolishing arrhythmia, and bipolar voltage electrogram's narrow field of view can be further reduced for increased sensitivity. In this report, we perform cardiac mapping with monophasic action potential (MAP) amplitude. We hypothesize that MAP amplitude (MAPA) will provide more accurate infarct sizes than other mapping modalities via increased sensitivity to distinguish healthy myocardium from scar tissue. Using the left coronary artery ligation Sprague-Dawley rat model of ischemic heart failure, we investigate the accuracy of in vivo ventricular epicardial maps derived from MAPA, MAP duration to 90% repolarization (MAPD90), unipolar voltage amplitude (UVA), and bipolar voltage amplitude (BVA) compared with gold standard histopathological measurement of infarct size. Numerical analysis reveals discrimination of healthy myocardium versus scar tissue using MAPD90 (P = 0.0158) and UVA (P < 0.001, n = 21). MAPA and BVA decreased between healthy and border tissue (P = 0.0218 and 0.0015, respectively) and border and scar tissue (P = 0.0037 and 0.0094, respectively). Contrary to our hypothesis, BVA mapping performed most accurately regarding quantifying infarct size. MAPA mapping may have high spatial resolution for myocardial tissue characterization but was quantitatively less accurate than other mapping methods at determining infarct size. BVA mapping's superior utility has been reinforced, supporting its use in translational research and clinical electrophysiology laboratories. MAPA may hold potential value for precisely distinguishing healthy myocardium, border zone, and scar tissue in diseases of disseminated fibrosis such as atrial fibrillation. NEW & NOTEWORTHY Monophasic action potential mapping in a clinically relevant model of heart failure with potential implications for atrial fibrillation management.Note
12 month embargo; available online 19 Sep 2019ISSN
0363-6135EISSN
1522-1539PubMed ID
31347917Version
Final accepted manuscriptSponsors
National Heart, Lung, and Blood InstituteUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Heart Lung & Blood Institute (NHLBI) [HL-007249-43]; WARMER Research Foundation; Martin and Carol Reid Charitable Remainder Trust; Sarver Heart Center, University of Arizonaae974a485f413a2113503eed53cd6c53
10.1152/ajpheart.00225.2019