Repolarization time map in catheter ablation for scar‐related reentrant ventricular tachycardia

Figures

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  FIGURE 1. Box plots of the areas of interest and the concordance rates with the ventricular tachycardia (VT) isthmus. (A) The areas of interest for each method: From left to right, the bars represent the bipolar low‐voltage area (LVA), unipolar LVA, deceleration zones (DZ) identified by isochronal late activation mapping (ILAM), and regions with short repolarization times (RT). (B) The concordance rates between the region of interest and the VT isthmus: The arrangement of the figures and abbreviations is the same as in (A).

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  FIGURE 2. A representative case of complete concordance between the short RT region and the VT isthmus. (A) Intracardiac electrocardiogram during VT in a patient with hypertrophic cardiomyopathy. A multipolar electrode catheter (the Adviser HD Grid) positioned at the left ventricular apex, shown as a white circle in panel (B). (B) The geometries display the RAO view of the left ventricle. (C) RT map; the unipolar morphologies at the point of the shortest RT (1) and the point of the latest RT (2). White arrows indicate the maximal dV/dt point of the J‐ST segment. (D) Comparison of the endocardial and epicardial RT maps. The left panel illustrates the endocardial map, while the right panel depicts the epicardial map, both corresponding to the Left Anterior Oblique 45° view. RAO, right anterior oblique; RT, repolarization times; VT, ventricular tachycardia.

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  FIGURE 3. A representative case of adjacent short RT area and DZ. (A) Intracardiac electrocardiogram during VT in a patient with arrhythmogenic ventricular cardiomyopathy. The ablation catheter is positioned at the lateral site of the tricuspid annulus, shown as a white circle in panel (B). (B) The geometries display the RAO view of the right ventricle. (C) RT map; the unipolar morphologies at the point of the shortest RT (1) and the point of the latest RT (2). White arrows indicate the termination of the RT. DZ, deceleration zone; RAO, right anterior oblique; RT, repolarization times; VT, ventricular tachycardia.

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  FIGURE 4. A representative case of the spatial relationship between the VT isthmus, the DZ, and the short RT area. (A) Activation map of scar‐related VT. (B) The DZs identified by ILAM are represented as pink circles. (C) RT map; regions with short RT are indicated in white. Yellow lines denote the line of block, and the white circles represent the areas where diastolic potentials were recorded during the VT. DZ, deceleration zone; ILAM, isochronal late activation map; RT, repolarization times; VT, ventricular tachycardia.

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  FIGURE 5. Kaplan–Meier curves depicting freedom from VT recurrences. (A) A red line indicates subjects in whom the regions targeted for catheter ablation were concordant with DZs; a blue line indicates those incongruent with DZs. (B) A red line indicates subjects in whom the regions targeted for catheter ablation were concordant with the short RT area; a blue line indicates those incongruent with the short RT area. DZ, deceleration zone; RT, repolarization times; VT, ventricular tachycardia.