Aims Patients with ischaemic cardiomyopathy (ICM) referred for catheter ablation of ventricular tachycardia (VT) are at risk for end-stage heart failure (HF) due to adverse remodelling. Local unipolar voltages (UV) decrease with loss of viable myocardium. A UV parameter reflecting global viable myocardium may predict prognosis. We evaluate if a newly proposed parameter, area-weighted unipolar voltage (awUV), can predict HF-related outcomes [HFO; HF death/left ventricular (LV) assist device/heart transplant] in ICM. Methods and results From endocardial voltage maps of consecutive patients with ICM referred for VT ablation, awUV was calculated by weighted interpolation of local UV. Associations between clinical and mapping parameters and HFO were evaluated and validated in a second cohort. The derivation cohort consisted of 90 patients [age 68 ±8 years; LV ejection fraction (LVEF) 35% interquartile range (IQR) (24–40)] and validation cohort of 60 patients [age 67 ± 9, LVEF 39% IQR (29–45)]. In the derivation cohort, during a median follow-up of 45 months [IQR (34–83)], 36 (43%) patients died and 23 (26%) had HFO. Patients with HFO had lower awUV [4.51 IQR (3.69–5.31) vs. 7.03 IQR (6.08–9.2), P < 0.001]. A reduction in awUV [optimal awUV (5.58) cut-off determined by receiver operating characteristics analysis] was a strong predictor of HFO (3-year HFO survival 97% vs. 57%). The cut-off value was confirmed in the validation cohort (2-year HFO-free survival 96% vs. 60%). Conclusion The newly proposed parameter awUV, easily available from routine voltage mapping, may be useful at identifying ICM patients at high risk for HFO.

中文翻译：

---

面积加权单极电压预测缺血性心肌病和室性心动过速患者心力衰竭的结果

转诊接受室性心动过速 (VT) 导管消融术的缺血性心肌病 (ICM) 患者由于不良重构而面临终末期心力衰竭 (HF) 的风险。局部单极电压（UV）随着存活心肌的丧失而降低。反映整体存活心肌的紫外线参数可以预测预后。我们评估新提出的参数面积加权单极电压 (awUV) 是否可以预测 HF 相关结果 [HFO; ICM 中的心力衰竭死亡/左心室 (LV) 辅助装置/心脏移植]。方法和结果 根据连续进行 VT 消融的 ICM 患者的心内膜电压图，通过局部 UV 加权插值计算 awUV。在第二组中评估和验证了临床和绘图参数与 HFO 之间的关联。衍生队列由 90 名患者组成 [年龄 68 ± 8 岁；左室射血分数 (LVEF) 35% 四分位距 (IQR) (24–40)] 和 60 名患者的验证队列 [年龄 67 ± 9，LVEF 39% IQR (29–45)]。在衍生队列中，在 45 个月的中位随访期间 [IQR (34-83)]，36 名 (43%) 患者死亡，23 名 (26%) 患者患有 HFO。 HFO 患者的 awUV 较低 [4.51 IQR (3.69–5.31) vs. 7.03 IQR (6.08–9.2)，P < 1。 0.001]。 awUV 的减少 [通过接受者操作特征分析确定的最佳 awUV (5.58) 截止值] 是 HFO 的有力预测因子（3 年 HFO 生存率为 97% vs. 57%）。截止值在验证队列中得到确认（2 年无 HFO 生存率 96% 对比 60%）。结论 新提出的参数 awUV 可以从常规电压映射中轻松获得，可能有助于识别 HFO 高风险的 ICM 患者。