Contemporary electroanatomical mapping and arrhythmogenic substrate modification have emerged as key strategies to improve outcomes in atrial fibrillation and ventricular tachycardia ablation.
Cardiac electrophysiology has moved a long way forward during recent decades in the comprehension and treatment of complex cardiac arrhythmias. Contemporary electroanatomical mapping systems, along with state-of-the-art technology in the manufacture of electrophysiology catheters and cardiac imaging modalities, have significantly enriched our armamentarium, enabling the implementation of various mapping strategies and techniques in electrophysiology procedures. Beyond conventional mapping strategies, ablation of complex fractionated electrograms and rotor ablation in atrial fibrillation ablation procedures, the identification and modification of the underlying arrhythmogenic substrate has emerged as a strategy that leads to improved outcomes. Arrhythmogenic substrate modification also has a major role in ventricular tachycardia ablation procedures. Optimisation of contact between tissue and catheter and image integration are a further step forward to augment our precision and effectiveness. Hybridisation of existing technologies with a reasonable cost should be our goal over the next few years.
Koutalas et al. (Thu,) conducted a review in Complex cardiac arrhythmias. Contemporary mapping techniques and arrhythmogenic substrate modification was evaluated. Contemporary electroanatomical mapping and arrhythmogenic substrate modification have emerged as key strategies to improve outcomes in atrial fibrillation and ventricular tachycardia ablation.