Key result
Surface conduction velocity estimates require tight electrode spacing near the pacing site to match tissue velocity.
Why the study?
Ignoring the 3-dimensional aspect introduces major error into conduction velocity measurements, prompting evaluation of whether a specific region exists where conduction velocity can be accurately measured.
Can surface conduction velocity accurately measure true tissue conduction velocity in 3-dimensional ventricles?
Can surface conduction velocity accurately measure true tissue conduction velocity in 3-dimensional ventricles?
Surface conduction velocity measurements are only accurate when taken close to the pacing site (<2 cm) with fine electrode spacing (≤1 mm), as the Purkinje system and fiber orientation otherwise introduce significant error.
Answers are grounded in this paper and cite their sources.
Surface CV measurements warrant caution in ventricular mapping; leaves open in vivo validation of close-proximity protocols.
BACKGROUND: Conduction velocity (CV) is a measure of the health of myocardial tissue. It can be measured by taking differences in local activation times from intracardiac electrodes. Several factors introduce error into the measurement, among which ignoring the 3-dimensional aspect is a major detriment. OBJECTIVES: The purpose of this study was to determine if, nonetheless, there was a specific region where CV could be accurately measured. METHODS: Computer simulations of 3-dimensional ventricles with a realistic His-Purkinje system were performed. Ventricles also included a dense scar or diffuse fibrosis. RESULTS: A finer spatial sampling produced better agreement with true CV. Using an error limit of 10 cm/s as a threshold, measurements taken within a region <2 cm from the pacing site proved to be accurate. Error increased abruptly beyond this distance. The Purkinje system and tissue fiber orientation played equally major roles in leading to a surface CV that was not reflective of the CV propagation through the tissue. CONCLUSIONS: In general, surface CV correlates poorly with tissue CV. Only surface CV measurements close to the pacing site, taken with an electrode spacing of ≤1 mm, give reasonable estimates.
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Vigmond et al. (2025) studied Myocardial tissue health. Surface conduction velocity measurement vs. True tissue conduction velocity was evaluated on Accuracy of surface conduction velocity compared to true tissue conduction velocity. Surface conduction velocity measurements correlate poorly with tissue conduction velocity, but estimates are accurate (error <10 cm/s) when taken <2 cm from the pacing site with ≤1 mm electrode spacing.
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