AuthorChinyere, Ikeotunye Royal
AffiliationUniv Arizona, Sarver Heart Ctr
Univ Arizona, Coll Med
MetadataShow full item record
PublisherAMER PHYSIOLOGICAL SOC
CitationChinyere, 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.
RightsCopyright © 2019 the American Physiological Society
Collection InformationThis 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 email@example.com.
AbstractAlthough 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.
Note12 month embargo; available online 19 Sep 2019
VersionFinal accepted manuscript
SponsorsNational 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 Arizona
- In vivo Electrophysiological Study of Induced Ventricular Tachycardia in Intact Rat Model of Chronic Ischemic Heart Failure.
- Authors: Weigand K, Witte R, Moukabary T, Chinyere I, Lancaster J, Pierce MK, Goldman S, Juneman E
- Issue date: 2017 Jun
- Application of ripple mapping to visualize slow conduction channels within the infarct-related left ventricular scar.
- Authors: Jamil-Copley S, Vergara P, Carbucicchio C, Linton N, Koa-Wing M, Luther V, Francis DP, Peters NS, Davies DW, Tondo C, Della Bella P, Kanagaratnam P
- Issue date: 2015 Feb
- Influence of Intramyocardial Adipose Tissue on the Accuracy of Endocardial Contact Mapping of the Chronic Myocardial Infarction Substrate.
- Authors: Samanta R, Kumar S, Chik W, Qian P, Barry MA, Al Raisi S, Bhaskaran A, Farraha M, Nadri F, Kizana E, Thiagalingam A, Kovoor P, Pouliopoulos J
- Issue date: 2017 Oct
- Impact of Ischemic and Valvular Heart Disease on Atrial Excitation:A High-Resolution Epicardial Mapping Study.
- Authors: Mouws EMJP, Lanters EAH, Teuwen CP, van der Does LJME, Kik C, Knops P, Yaksh A, Bekkers JA, Bogers AJJC, de Groot NMS
- Issue date: 2018 Mar 8
- Impact of Voltage Mapping to Guide Whether to Perform Ablation of the Posterior Wall in Patients With Persistent Atrial Fibrillation.
- Authors: Cutler MJ, Johnson J, Abozguia K, Rowan S, Lewis W, Costantini O, Natale A, Ziv O
- Issue date: 2016 Jan