Isolated Potentials During Sinus Rhythm and Pace-Mapping Within Scars as Guides for Ablation of Post-Infarction Ventricular Tachycardia

摘要: Objectives The purpose of this study was to identify ventricular tachycardia (VT) isthmus sites by pace-mapping within scar tissue and electrogram characteristics that are helpful in identifying VT during sinus rhythm (SR). Background Pace-mapping has been used the border zone exit site post-infarction VT. Methods In 19 consecutive patients (18 men, mean age 66 ± 9 years, ejection fraction 0.24 0.12) with VT, a left voltage map generated SR. performed at abnormal electrograms or isolated potentials. Radiofrequency ablation as defined (perfect pace-map = 12/12 matching electrocardiogram leads; good 10/12 11/12 leads) and/or entrainment mapping. Results A total 81 VTs (mean cycle length 396 124 ms) were inducible. 16 patients, 41 distinct areas identified successfully ablated. All but one displayed potentials Furthermore, 22 (27%) for which no became noninducible after targeted whom ≥1 ablated free arrhythmic events follow-up 10 months. Conclusions During SR, excellent pace-maps fixed block protected part critical Shared common pathways might explain why non-targeted become other VTs.