Key result
Decrement-evoked potential polarity may help differentiate critical VT substrate from bystander regions during functional mapping.
Why the study?
Distinguishing arrhythmogenic from bystander decrement-evoked potentials during functional substrate mapping of ventricular tachycardia remains challenging.
Does DEEP polarity behavior help differentiate critical VT substrate from bystander regions in patients undergoing VT ablation?
Observational
Does DEEP polarity behavior help differentiate critical VT substrate from bystander regions in patients undergoing VT ablation?
DEEP polarity change between S1 and S2 pacing may serve as a novel electrophysiological marker to identify critical arrhythmogenic substrates during VT ablation.
Answers are grounded in this paper and cite their sources.
May refine functional mapping to better target VT ablation; leaves open validation in prospective studies before clinical adoption.
INTRODUCTION: Decrement-evoked potentials (DEEPs) are used to identify the functional substrate during ventricular tachycardia (VT) ablation, but distinguishing arrhythmogenic from bystander DEEPs remains challenging. METHODS AND RESULTS: During substrate-based VT ablation, DEEPs were analyzed using a predefined early evaluation window and dominant initial deflection during S1 pacing and S2 extrastimulus. DEEPs exhibiting polarity change between S1 and S2 were observed at the critical ablation site, whereas DEEPs without polarity change were found at non-critical sites. Ablation at the polarity-changing DEEP site was effective. CONCLUSION: DEEP polarity behavior may help differentiate critical VT substrate from bystander regions.
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Temma et al. (2026) conducted an observational in Ventricular tachycardia. Decrement-evoked potentials (DEEPs) polarity behavior analysis vs. DEEPs without polarity change was evaluated on Identification of critical ablation site. Decrement-evoked potentials exhibiting polarity change between S1 and S2 pacing identified critical ablation sites for ventricular tachycardia, whereas those without change indicated bystander sites.
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