Why the study?
Recent reports have highlighted the role of functional substrate mapping during sinus rhythm to predict the critical isthmus of left atrial tachycardias.
Does functional substrate mapping using atrial decrement evoked potentials predict the critical isthmus and guide successful ablation in recurrent atrial tachycardia?
Does functional substrate mapping using atrial decrement evoked potentials predict the critical isthmus and guide successful ablation in recurrent atrial tachycardia?
Functional substrate mapping using atrial decrement evoked potentials can identify the critical isthmus of atrial tachycardia even when sinus rhythm voltages are normal, guiding successful ablation.
May identify isthmus targets in select atrial tachycardia cases; hypothesis-generating pending prospective validation.
Recent reports highlighted the role of functional substrate mapping during sinus rhythm to predict the critical isthmus of left atrial tachycardias (AT). In this article, we reported a case of a 63-year-old female patient who was admitted with recurrent AT after pulmonary vein isolation. Although sinus rhythm revealed normal left atrium voltages, programmed stimulation with extrastimulus revealed decrement evoked potentials with prolongation in local electrograms on the anterior wall. Critical isthmus of AT was colocalized with deceleration zones during functional substrate mapping. Radiofrequency ablation successfully terminated AT.
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Yorgun et al. (2025) studied this question.
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