Why the study?
Does altering the activation wavefront improve the detection of arrhythmogenic substrate and critical sites for reentry in patients with unmappable VTs?
Does altering the activation wavefront improve the detection of arrhythmogenic substrate and critical sites for reentry in patients with unmappable VTs?
Using an alternate activation wavefront perpendicular to the VT isthmus may increase sensitivity for detecting arrhythmogenic substrate in unmappable ventricular tachycardias.
Alternate wavefront mapping may enhance substrate detection in unmappable VT; hypothesis-generating and requires validation before practice change.
, P=0.01). All patients had successful VT isthmus ablation. In 11±8 months follow-up, 2 patients had a recurrence. Conclusions Wavefronts of conduction slowing/block may aid identification of critical isthmuses in unmappable VTs. Altering the activation wavefront leads to significant differences in conduction properties of myocardial tissue, along with scar and LAVA characterization. In patients where few LAVAs are identified during substrate mapping, using an alternate activation wavefront running perpendicular to the VT isthmus may increase sensitivity to detect arrhythmogenic substrate and critical sites for reentry.
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Martin et al. (2019) studied this question.
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