Meeting 3 specific mapping criteria predicted ventricular tachycardia termination by a single radiofrequency lesion in 100% (19/19) of sites vs 4% (1/25) of sites lacking all criteria (P<0.0005).
Observational (n=15)
Does meeting three specific entrainment and mapping criteria predict the successful termination of ventricular tachycardia by a single radiofrequency lesion in patients with coronary artery disease?
Meeting three specific entrainment and mapping criteria highly predicts the successful termination of infarct-related ventricular tachycardia with a single radiofrequency lesion, minimizing the number of lesions required.
Absolute Event Rate: 100% vs 4%
p-value: p=<0.0005
BACKGROUND: A variety of mapping criteria have been proposed to localize critical sites at which radiofrequency (RF) can predictably terminate reentrant ventricular tachycardia (VT) caused by coronary artery disease. The purpose of this study was to determine the accuracy of using a combination of 3 mapping criteria in predicting termination of VT by a single RF lesion. METHODS AND RESULTS: Fifteen consecutive patients with coronary artery disease and recurrent sustained VT underwent an attempted RF ablation of 20 monomorphic VTs. Successful termination of VT by a single RF lesion was predicted if all the following mapping criteria were met: (1) an exact QRS match in the 12-lead ECG during entrainment; (2) a return cycle length </=10 ms of the VT cycle length; (3) presystolic potentials (<70% of VT cycle length) with an activation time to the QRS within 10 ms of the stimulus to QRS. Inability to meet these 3 criteria was considered to predict failure of VT termination by RF energy at that site. RF ablation was applied to 44 left ventricular sites in 20 VTs at which at least 1 of the mapping criteria was met. VT was terminated with a single RF lesion in 19 of 19 sites meeting all criteria; RF failed to terminate VT at 24 of 25 sites at which all 3 criteria were not met (P<0.0005). CONCLUSIONS: To maximize success and minimize the number of RF lesions in patients with infarct-related VT, all the above 3 mapping criteria should be met before the application of RF energy.
El‐Shalakany et al. (Tue,) conducted a observational in Coronary artery disease and recurrent sustained ventricular tachycardia (n=15). Combination of 3 mapping criteria vs. Sites not meeting all 3 mapping criteria was evaluated on Termination of ventricular tachycardia by a single radiofrequency lesion (p=<0.0005). Meeting 3 specific mapping criteria predicted ventricular tachycardia termination by a single radiofrequency lesion in 100% (19/19) of sites vs 4% (1/25) of sites lacking all criteria (P<0.0005).