What question did this study set out to answer?

This research aims to improve the understanding and localization of reentrant circuits in ventricular tachycardia after myocardial infarction.

April 22, 2026Open Access

Exploring Postinfarction Reentrant Ventricular Tachycardia With Entrainment Mapping

Q: What is the clinical evidence from this study?

Study design: Review. Population: Postinfarction Reentrant Ventricular Tachycardia. Intervention: Entrainment mapping.

Key Result

Entrainment mapping allows identification of reentry circuit isthmuses without locating the entire circuit, predicting the likelihood that radiofrequency ablation will terminate ventricular tachycardia.

Key Points

This research aims to improve the understanding and localization of reentrant circuits in ventricular tachycardia after myocardial infarction.
Utilized pacing through mapping catheter electrodes to define reentry circuits.
Identified isthmuses where radiofrequency catheter ablation can interrupt reentry.
Developed a classification system for reentry circuits to predict outcomes of ablation.
Successful identification of several key portions of the reentry circuit using pacing stimuli.
Classification of reentry circuits into functional components improved understanding of reentrant behavior.
Pacing strategies allow for targeting areas amenable to ablation therapy.

Structured PICO

How does entrainment mapping help in identifying reentry circuits for radiofrequency ablation in postinfarction ventricular tachycardia?

Population

Patients with postinfarction reentrant ventricular tachycardia

Intervention

Entrainment mapping (pacing through mapping catheter electrodes) and radiofrequency catheter ablation

Outcome

Identification of reentry circuit components and isthmuses for ablation

Entrainment mapping is a valuable technique for identifying critical isthmuses in complex postinfarction ventricular tachycardia reentry circuits, facilitating targeted radiofrequency ablation.

Abstract

Ventricular tachycardia late after myocardial infarction is usually due to reentry in the infarct region. These reentry circuits can be large, complex and difficult to define, impeding study in the electrophysiology laboratory and making catheter ablation difficult. Pacing through the electrodes of the mapping catheter provides a new approach to mapping. When pacing stimuli capture the effects on the tachycardia depend on the location of the pacing site relative to the reentry circuit. The effects observed allow identification of various portions of the reentry circuit, without the need for locating the entire circuit. Isthmuses where relatively small lesions produced by radiofrequency catheter ablation can interrupt reentry can often be identified. A classification that divides reentry circuits into one or more functional components helps to conceptualize the reentry circuit and predicts the likelihood that heating with radiofrequency current will terminate tachycardia. These methods are helping to define human reentry circuits. (J Am Coll Cardiol 1997;29:1180–9)