What does this research mean for the field?

Marked stimulus-to-QRS conduction delays (>80 ms) detected by pace-mapping are significantly more likely to localize within post-infarction ventricular tachycardia re-entry circuit target areas than moderate delays. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To characterize the relationship between conduction delays identified during pace-mapping and post-infarction ventricular tachycardia re-entry circuit isthmuses.

August 19, 2026Journal of the American College of CardiologyOpen Access

Relationship of slow conduction detected by pace-mapping to ventricular tachycardia re-entry circuit sites after infarction

Q: What are the key findings of this study?

Marked conduction delays >80 ms during pace-mapping were more often located in VT re-entry circuit target regions than delays of 40 to 80 ms (52% vs 29%, p<0.0001).

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Ventricular tachycardia after infarction (n=12). Intervention: Marked conduction delays (>80 ms) during pace-mapping vs. Conduction delays of 40 to 80 ms. Primary outcome: Location within a target region (re-entry circuit isthmus) (p=< 0.0001).

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Key result

Pace-mapping delays >80 ms identify VT re-entry targets ~79% more often than shorter delays.

P<0.0001
n=12

Why the study?

Areas of slow conduction and block in old infarcts cause re-entrant VT, but the relationship between conduction delays detected by pace-mapping and VT re-entry circuit isthmuses remained to be characterized.

Does pace-mapping to detect slow conduction identify VT re-entry circuit isthmuses in patients with post-infarction VT?

Key Points

To characterize the relationship between conduction delays identified during pace-mapping and post-infarction ventricular tachycardia re-entry circuit isthmuses.
Evaluated 12 post-infarction ventricular tachycardia patients undergoing electrophysiological pace-mapping across 890 left ventricular sites mapped in 3D reconstructions.
Defined conduction delay as a stimulus-to-QRS (S-QRS) interval ≥40 ms and marked delay as >80 ms, comparing their distribution to 14 target areas within 2 cm of an identified re-entry isthmus.
Pacing captured at 829 sites, with 364 (44%) demonstrating an S-QRS delay ≥40 ms and 127 (15%) showing a delay >80 ms, clustering into 14 discrete regions that overlapped 13 of 14 target zones.
Sites with marked delays (>80 ms) were significantly more likely to reside within target isthmus regions than sites with moderate delays of 40 to 80 ms (52% vs 29%, p < 0.0001).

Study Design

Type

Observational (n=12)

Structured PICO

Does pace-mapping to detect slow conduction identify VT re-entry circuit isthmuses in patients with post-infarction VT?

Population

12 patients with ventricular tachycardia after infarction undergoing pace-mapping.

Exposure

Pace-mapping to detect conduction delays (stimulus to QRS interval delay ≥40 ms)

Outcome

Location of conduction delays compared to locations of VT re-entry circuit isthmuses (target areas)surrogate

Main Result

Absolute Event Rate: 52% vs 29%

p-value: p=< 0.0001

Discussion

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Implication

Identification of abnormal conduction during pace-mapping can focus mapping during induced VT to discrete regions of the infarct, potentially aiding ablation strategies.

Cite This Study

Brunckhorst et al. (2003) conducted an observational in Ventricular tachycardia after infarction (n=12). Marked conduction delays (>80 ms) during pace-mapping vs. Conduction delays of 40 to 80 ms was evaluated on Location within a target region (re-entry circuit isthmus) (p=< 0.0001). Marked conduction delays >80 ms during pace-mapping were more often located in VT re-entry circuit target regions than delays of 40 to 80 ms (52% vs 29%, p<0.0001).

synapsesocial.com/papers/6a85750054da1e76a74cb101 https://doi.org/10.1016/s0735-1097(02)02932-7

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Implication

Identification of abnormal conduction during pace-mapping can focus mapping during induced VT to discrete regions of the infarct, potentially aiding ablation strategies.

Relationship of slow conduction detected by pace-mapping to ventricular tachycardia re-entry circuit sites after infarction

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Relationship of slow conduction detected by pace-mapping to ventricular tachycardia re-entry circuit sites after infarction

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

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