Entrainment mapping allows identification of reentry circuit isthmuses without locating the entire circuit, predicting the likelihood that radiofrequency ablation will terminate ventricular tachycardia.
How does entrainment mapping help in identifying reentry circuits for radiofrequency ablation in postinfarction ventricular tachycardia?
Entrainment mapping is a valuable technique for identifying critical isthmuses in complex postinfarction ventricular tachycardia reentry circuits, facilitating targeted radiofrequency ablation.
Ventricular tachycardia late after myocardial infarction is usually due to reentry in the infarct region. These reentry circuits can be large, complex and difficult to define, impeding study in the electrophysiology laboratory and making catheter ablation difficult. Pacing through the electrodes of the mapping catheter provides a new approach to mapping. When pacing stimuli capture the effects on the tachycardia depend on the location of the pacing site relative to the reentry circuit. The effects observed allow identification of various portions of the reentry circuit, without the need for locating the entire circuit. Isthmuses where relatively small lesions produced by radiofrequency catheter ablation can interrupt reentry can often be identified. A classification that divides reentry circuits into one or more functional components helps to conceptualize the reentry circuit and predicts the likelihood that heating with radiofrequency current will terminate tachycardia. These methods are helping to define human reentry circuits. (J Am Coll Cardiol 1997;29:1180–9)
Stevenson et al. (Thu,) conducted a review in Postinfarction Reentrant Ventricular Tachycardia. Entrainment mapping was evaluated. Entrainment mapping allows identification of reentry circuit isthmuses without locating the entire circuit, predicting the likelihood that radiofrequency ablation will terminate ventricular tachycardia.