Key result
In computer simulations of infarcted hearts, thin conducting isthmuses (0.2 mm) and fibrosis in the border zone increased the probability of premature ventricular complexes up to 55% by reducing electrotonic load.
Absolute Event Rate: 55% vs 0%
In-silico modeling demonstrates that thin isthmuses and specific thresholds of fibrosis in the infarct border zone promote calcium-mediated ectopy and conduction block, suggesting these microscopic structures as potential ablation targets.
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Hypothesis-generating for isthmus ablation in post-MI VT; prospective validation required before any clinical consideration.
Campos et al. (2018) studied Myocardial infarction and ventricular tachycardia. Thin conducting isthmuses and fibrosis in the infarct border zone (in-silico model) vs. Macroscopic isthmuses or no fibrosis was evaluated on Probability of premature ventricular complexes (pPVC). In computer simulations of infarcted hearts, thin conducting isthmuses (0.2 mm) and fibrosis in the border zone increased the probability of premature ventricular complexes up to 55% by reducing electrotonic load.
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