Relation of the unipolar low-voltage penumbra surrounding the endocardial low-voltage scar to ventricular tachycardia circuit sites and ablation outcomes in ischemic cardiomyopathy.

摘要: VT Recurrence as Related to Scar Ablation Sites Introduction Magnetic resonance (MR)-imaging has shown that infarct scars causing ventricular tachycardia (VT) can extend deep and beyond bipolar low-voltage areas (LVAs) may be a source of ablation failure. We hypothesized the size unipolar LVA “penumbra” overlying scar predict outcome endocardial ablation. Methods Twenty consecutive patients with ischemic cardiomyopathy who underwent were retrospectively reviewed. Bipolar (30–500 Hz) defined <1.5 mV (0.5–500 <8.3 reviewed on an electroanatomic mapping system. isthmus sites identified from entrainment mapping, termination by ablation, or pace-mapping abolition inducibility ablation. Results All LVAs (70.5 ± 20 cm2) had surrounded (147 47 cm2). Only 58% induced VTs could mapped ablated. During 3-month follow-up 8/20 recurrence. The penumbra was not different for those (88 versus without (69 35 recurrences. However, all (8/8) group recurred isthmus/exits in border compared only 3/12 did recur (100% vs. 25%; P < 0.05). Furthermore, 5/8 harbored isthmuses than 1/12 (63% 8%; = 0.01). Conclusion In cardiomyoapthy, varying surrounds LVA, indicating intramural/epicardial scar. Although this area early recurrence after frequent recurrences at periphery suggests deeper substrate toward border.