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Updated: Aug 20, 2025

A Method for Tracking the Time Evolution of Steady-State Evoked Potentials

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Published on: May 25, 2019

Simultaneous Entrainment Response Assessment at Multiple Sites.

Paweł Derejko¹, Piotr Podziemski², Aleksander Bardyszewski³

¹Cardiac Arrhythmias Department, National Institute of Cardiology, Warsaw, Poland; Department of Cardiology, Medicover Hospital Warsaw, Warsaw, Poland.

JACC. Clinical Electrophysiology

|November 24, 2022

Summary

The postpacing interval measured remotely (PPIR) helps map tachycardia circuits. A PPIR-TCL difference over 20 milliseconds reliably indicates pacing sites outside the tachycardia circuit.

Keywords:

electrophysiology mapping entrainment re-entry

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Area of Science:

Electrophysiology
Cardiac Arrhythmias
Cardiovascular Mapping

Background:

The entrainment response, a difference between postpacing interval and tachycardia cycle length (TCL), aids in identifying tachycardia circuit components.
Accurate mapping of re-entrant circuits is crucial for effective tachycardia management.

Purpose of the Study:

To assess the clinical utility of the postpacing interval measured remotely (PPIR) for mapping re-entrant circuits.
To determine if simultaneous PPIR measurements from multiple remote sites improve tachycardia circuit localization.

Main Methods:

Evaluated 92 entrainment response episodes in 29 patients with macro-re-entrant tachycardias using a standardized protocol.
Analyzed spatial distribution of PPIR-TCL values in simulations and a computational model of re-entrant tachycardia.

Main Results:

A PPIR-TCL difference exceeding 20 milliseconds occurred only when both pacing and recording sites were outside the tachycardia circuit.
PPIR-TCL at in-circuit sites was consistently ≤20 milliseconds.
Negative PPIR-TCL values were observed at sites both inside and outside the tachycardia circuit.

Conclusions:

Assessing entrainment response from remote catheter sites can enhance spatial mapping of tachycardia circuits.
A PPIR-TCL difference greater than 20 milliseconds has high positive predictive value for identifying sites outside the tachycardia circuit.