Showing up channels for postinfarct ventricular tachycardia ablation.
The number of scar-related ventricular tachycardia (VT) ablation procedures is increasing worldwide. This is certainly due to the ever growing number of patients implanted with an implantable cardioverter defibrillator in whom an ablation procedure may be required to better control the ventricular arrhythmia burden, but is also likely related to our better understanding of the arrhythmias mechanisms as well as the improvement of the mapping techniques during the last 15 years. Most VTs, especially those arising after myocardial infarction, depend on a critical isthmus. Defining precisely the critical isthmus of postinfarct VT may be challenging, particularly when the arrhythmia is poorly tolerated. In the literature, there are extensive data concerning the value of conventional electrophysiological techniques, especially entrainment mapping in association with postpacing interval measurements, regarding the identification of postinfarct VT isthmuses. There are, however, other--sometimes emerging--approaches to image critical postinfarct VT channels. We have summarized these, reviewing data from the published literature as well as our own experience.
Département de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux & Université Henri Poincaré, Nancy, France. c.dechillou@chu-nancy.fr
Christian
C
de Chillou
Isabelle
I
Magnin-Poull
Marius
M
Andronache
Frederic
F
Sacher
Laurent
L
Groben
Ahmed
A
Abdelaal
Lucian
L
Muresan
Soumaya
S
Jarmouni
Jerome
J
Schwartz
Pierre
P
Jaïs
Etienne
E
Aliot
D018780:Body Surface Potential Mapping / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*