46. Localization of the Arrhythmogenic Substrate in Non-ischemic Cardiomyopathy: Combined Endocardial and Epicardial Mapping and Ablation

  1. Mohammad Shenasa MD2,
  2. Gerhard Hindricks MD3,
  3. Martin Borggrefe MD4,
  4. Günter Breithardt MD5 and
  5. Mark E. Josephson MD6
  1. Nilesh S. Mathuria,
  2. Roderick Tung and
  3. Kalyanam Shivkumar

Published Online: 18 DEC 2012

DOI: 10.1002/9781118481585.ch46

Cardiac Mapping, Fourth Edition

Cardiac Mapping, Fourth Edition

How to Cite

Mathuria, N. S., Tung, R. and Shivkumar, K. (2013) Localization of the Arrhythmogenic Substrate in Non-ischemic Cardiomyopathy: Combined Endocardial and Epicardial Mapping and Ablation, in Cardiac Mapping, Fourth Edition (eds M. Shenasa, G. Hindricks, M. Borggrefe, G. Breithardt and M. E. Josephson), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118481585.ch46

Editor Information

  1. 2

    Attending Physician, Department of Cardiovascular Services, O'Connor Hospital, Heart & Rhythm Medical Group, San Jose, California, USA

  2. 3

    Professor of Medicine (Cardiology), University Leipzig, Heart Center, Director, Department of Electrophysiology, Leipzig, Germany

  3. 4

    Professor of Medicine (Cardiology), Head, Department of Cardiology, Angiology and Pneumology, University Medical Center, Mannheim Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany

  4. 5

    Professor Emeritus of Medicine and Cardiology, Department of Cardiology and Angiology, Hospital of the University of Münster, Münster, Germany

  5. 6

    Chief, Cardiovascular Medicine Division, Director, Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service, Beth Israel Deaconess Medical Center, Herman C. Dana Professor of Medicine, Harvard Medical School, Boston, Massachusetts, USA

Author Information

  1. UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

Publication History

  1. Published Online: 18 DEC 2012
  2. Published Print: 10 JAN 2013

ISBN Information

Print ISBN: 9780470670460

Online ISBN: 9781118481585



  • catheter ablation;
  • epicardial;
  • electroanatomic mapping;
  • non-ischemic cardiomyopathy;
  • ventricular tachycardia


Management of patients with non-ischemic cardiomyopathy (NICM) and ventricular tachycardia (VT) remains challenging. The role of catheter ablation for VT continues to evolve for these patients. Recent publications have described the location of the arrhythmogenic substrate for patients with NICM to be located along the basal left ventricle on both the endocardial and epicardial surface. Additionally, predictors for identifying whether mapping the endocardium or epicardial surface of the heart have been identified for successful ablation of VT in this patient population. This chapter reviews the known arrhythmogenic substrate in NICM, characterizes the location of this substrate, and provides predictors of identifying an endocardial and/or epicardial site for successful substrate modification.