50. Do Mapping Strategies Influence Outcomes in Ventricular Tachycardia Ablation?

  1. Mohammad Shenasa MD2,
  2. Gerhard Hindricks MD3,
  3. Martin Borggrefe MD4,
  4. Günter Breithardt MD5 and
  5. Mark E. Josephson MD6
  1. Pasquale Vergara,
  2. Nicola Trevisi and
  3. Paolo Della Bella

Published Online: 18 DEC 2012

DOI: 10.1002/9781118481585.ch50

Cardiac Mapping, Fourth Edition

Cardiac Mapping, Fourth Edition

How to Cite

Vergara, P., Trevisi, N. and Della Bella, P. (2013) Do Mapping Strategies Influence Outcomes in Ventricular Tachycardia 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.ch50

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. San Raffaele Hospital, Milan, Italy

Publication History

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

ISBN Information

Print ISBN: 9780470670460

Online ISBN: 9781118481585

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Keywords:

  • activation mapping;
  • entrainment;
  • pacemapping;
  • non-contact mapping;
  • multi-electrode array;
  • electroanatomical mapping;
  • substrate mapping;
  • late potentials;
  • ventricular tachycardia;
  • ablation

Summary

Ventricular tachycardia (VT) activation and entrainment mapping require reproducible arrhythmia inducibility, hemodynamic tolerance and stable VT morphology; those characteristics are present only in a minority of patients. A long stimulus-QRS interval during pacemapping suggests a local conduction delay and is predictive of successful VT ablation. Substrate mapping relies upon the information obtained during baseline rhythm to guide catheter ablation of VTs; it has the primary aim of reducing or eliminating the need of arrhythmia induction. Late potentials (LPs) are usually found in surviving myocardial areas in the context of scar tissue. The strategy of LP mapping and complete elimination provides an objective measure of substrate modification; it can be useful in patients without 12-lead ECG documentation of the VT and in those with no inducible VT.