Affiliation:
1. Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital Southern Medical University Guangzhou China
2. Heart Center of Zhujiang Hospital Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease Guangzhou China
3. Heart Center of Zhujiang Hospital Sino‐Japanese Cooperation Platform for Translational Research in Heart Failure Guangzhou China
4. Boston Scientific China Shanghai China
Abstract
AbstractBackgroundSubstrate‐based ablation can treat uninducible or hemodynamically instability scar‐related ventricular tachycardia (VT). However, whether a correlation exists between the critical VT isthmus and late activation zone (LAZ) during sinus rhythm (SR) is unknown.ObjectiveTo demonstrate the structural and functional properties of abnormal substrates and analyze the link between the VT circuit and abnormal activity during SR.MethodsThirty‐six patients with scar‐related VT (age, 50.0 ± 13.7 years and 86.1% men) who underwent VT ablation were reviewed. The automatic rhythmia ultrahigh resolution mapping system was used for electroanatomic substrate mapping. The clinical characteristics and mapping findings, particularly the LAZ characteristics during SR and VT, were analyzed. To determine the association between the LAZ during the SR and VT circuits, the LAZ was defined as five activation patterns: entrance, exit, core, blind alley, and conduction barrier.ResultsForty‐five VTs were induced in 36 patients, 91.1% of which were monomorphic. The LAZ of all patients was mapped during the SR and VT circuits, and the consistency of the anatomical locations of the LAZ and VT circuits was analyzed. Using the ultrahigh resolution mapping system, interconversion patterns, including the bridge, T, puzzle, maze, and multilayer types, were identified. VT ablation enabled precise ablation of abnormal late potential conduction channels.ConclusionFive interconversion patterns of the LAZ during the SR and VT circuits were summarized. These findings may help formulate more precise substrate‐based ablation strategies for scar‐related VT and shorter procedure times.
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Cited by
1 articles.
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