Structure and function of the ventricular tachycardia isthmus

Edward J. Ciaccio*, Elad Anter, James Coromilas, Elaine Y. Wan, Hirad Yarmohammadi, Andrew L. Wit, Nicholas S. Peters, Hasan Garan

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Catheter ablation of postinfarction reentrant ventricular tachycardia (VT) has received renewed interest owing to the increased availability of high-resolution electroanatomic mapping systems that can describe the VT circuits in greater detail, and the emergence and need to target noninvasive external beam radioablation. These recent advancements provide optimism for improving the clinical outcome of VT ablation in patients with postinfarction and potentially other scar-related VTs. The combination of analyses gleaned from studies in swine and canine models of postinfarction reentrant VT, and in human studies, suggests the existence of common electroanatomic properties for reentrant VT circuits. Characterizing these properties may be useful for increasing the specificity of substrate mapping techniques and for noninvasive identification to guide ablation. Herein, we describe properties of reentrant VT circuits that may assist in elucidating the mechanisms of onset and maintenance, as well as a means to localize and delineate optimal catheter ablation targets.

Original languageEnglish
Pages (from-to)137-153
Number of pages17
JournalHeart Rhythm
Volume19
Issue number1
DOIs
StatePublished - Jan 2022
Externally publishedYes

Funding

FundersFunder number
National Institutes of HealthR01HL152236
NIHR Bristol Biomedical Research Centre
British Heart FoundationRG/16/3/32175
Rosetrees Trust

    Keywords

    • Catheter ablation
    • Isthmus
    • Mapping
    • Reentrant circuit
    • Ventricular tachycardia

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