Monophasic action potential amplitude for substrate mapping

Ikeotunye Royal Chinyere, Mathew Hutchinson, Talal Moukabary, Jordan Lancaster, Steven Goldman, Elizabeth B Juneman

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)H667-H673
JournalAmerican journal of physiology. Heart and circulatory physiology
Volume317
Issue number4
DOIs
StatePublished - Oct 1 2019

Fingerprint

Action Potentials
Cicatrix
Myocardium
Atrial Fibrillation
Cardiac Arrhythmias
Heart Failure
Translational Medical Research
Electrophysiology
Tachycardia
Ligation
Sprague Dawley Rats
Coronary Vessels
Fibrosis
Recurrence

Keywords

  • action potential
  • mapping
  • rat
  • voltage

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Monophasic action potential amplitude for substrate mapping. / Chinyere, Ikeotunye Royal; Hutchinson, Mathew; Moukabary, Talal; Lancaster, Jordan; Goldman, Steven; Juneman, Elizabeth B.

In: American journal of physiology. Heart and circulatory physiology, Vol. 317, No. 4, 01.10.2019, p. H667-H673.

Research output: Contribution to journalArticle

Chinyere, Ikeotunye Royal ; Hutchinson, Mathew ; Moukabary, Talal ; Lancaster, Jordan ; Goldman, Steven ; Juneman, Elizabeth B. / Monophasic action potential amplitude for substrate mapping. In: American journal of physiology. Heart and circulatory physiology. 2019 ; Vol. 317, No. 4. pp. H667-H673.
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