BACKGROUND The analysis of the wave-front activation patterns is crucial for the comprehension and treatment of ventricular tachycardia (VT). The ventricular electrograms duration map (VEDUM) is a potential method to identify areas (VEDUM area) with slow and inhomogeneous activation. There is no available data on the characteristics and the arrhythmogenic role of VEDUM areas identified during sinus/paced rhythm. METHODS Patients referred for VT ablation were enrolled at 3 different centers. VEDUM maps during sinus/paced rhythm as well as substrate and functional maps were created; activation mapping was performed for all hemodynamically tolerated VT. RESULTS Thirty-two patients (mean age:70.1±9.4 years; males 93.8%) were enrolled. The VEDUM approach was achieved in all patients and the mean size of the VEDUM area was 12.1±6.9 cm2 (interquartile range, 7.8-14.9 cm2). A significative difference was observed between the electrogram duration in the VEDUM area and the normal tissue (163.7 ms [interquartile range, 142.3-199.2 ms]; versus 65.5 ms [interquartile range, 59.5-76.2 ms]; P<0.001). The VEDUM area was visualized in a dense scar (<0.5 mV) in 19 (59.4%) patients. A deceleration zone and late potentials were recorded inside the VEDUM area in 56.3% and 81.3%, respectively. When a complete VT activation mapping was available, the isthmus projected in the VEDUM area in 93.5% of patients; 8 of them had multiple VTs mapped and in the 87.5% all VT isthmuses were included in the VEDUM area. CONCLUSIONS VEDUM maps allow the identification of discrete areas of inhomogeneous and slow conduction. They represent a potential target for VT ablation, including patients with multiple morphologies.

中文翻译：

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用于检测室性心律失常基质的心室电图持续时间图：VEDUM 项目研究。

背景波前激活模式的分析对于室性心动过速（VT）的理解和治疗至关重要。心室电图持续时间图 (VEDUM) 是识别缓慢且不均匀激活的区域（VEDUM 区域）的潜在方法。没有关于窦性/起搏心律期间识别的 VEDUM 区域的特征和致心律失常作用的可用数据。方法 转诊接受 VT 消融的患者在 3 个不同的中心进行登记。创建了窦性/起搏心律期间的 VEDUM 图以及基质图和功能图；对所有血流动力学耐受的 VT 进行激活映射。结果 纳入 32 名患者（平均年龄：70.1±9.4 岁；男性 93.8%）。所有患者均采用 VEDUM 方法，VEDUM 区域的平均大小为 12.1±6.9 cm2（四分位数范围，7.8-14.9 cm2）。在 VEDUM 区域和正常组织的电描记图持续时间之间观察到显着差异（163.7 ms [四分位间距，142.3-199.2 ms]；对比 65.5 ms [四分位间距，59.5-76.2 ms]；P<0.001）。19 名 (59.4%) 患者的 VEDUM 区域在致密疤痕 (<0.5 mV) 中可见。VEDUM 区域内记录的减速区和晚电位分别为 56.3% 和 81.3%。当获得完整的 VT 激活图时，93.5% 的患者峡部投射在 VEDUM 区域；其中 8 个映射了多个 VT，其中 87.5% 的所有 VT 峡部都包含在 VEDUM 区域中。结论 VEDUM 图可以识别不均匀和缓慢传导的离散区域。它们代表了 VT 消融的潜在目标，包括具有多种形态的患者。