title: Approach to ablation of unmappable ventricular arrhythmias.
abstract: Most patients with structural heart disease referred for ventricular tachycardia ablation have unstable tachycardias not suitable for conventional mapping (ie, entrainment mapping). Substrate-guided mapping and ablation during sinus rhythm are intended to overcome the limitations of conventional mapping and ablation. Substrate ablation permits elimination of multiple ventricular tachycardias irrespective of their inducibility during the procedure or their hemodynamic tolerability. Moreover, the elimination/isolation of the arrhythmogenic substrate identified during sinus rhythm has been associated with better outcomes. There is currently no standardized approach for substrate-guided ablation. This article discusses the main aspects of the proposed techniques and substrate ablation targets.
authors: Arrhythmia Section, Cardiology Department, Puerta del Mar University Hospital, Cádiz, Spain.
authors: Juan
authors: J
authors: Fernández-Armenta
authors: Arrhythmia Section, Cardiology Department, Hospital Clínic and IDIBAPS (Institut d'Investigació Agustí Pi i Sunyer), Barcelona, Spain.
authors: Diego
authors: D
authors: Penela
authors: Arrhythmia Section, Cardiology Department, Hospital Clínic and IDIBAPS (Institut d'Investigació Agustí Pi i Sunyer), Barcelona, Spain.
authors: Juan
authors: J
authors: Acosta
authors: Arrhythmia Section, Cardiology Department, Hospital Clínic and IDIBAPS (Institut d'Investigació Agustí Pi i Sunyer), Barcelona, Spain.
authors: David
authors: D
authors: Andreu
authors: Arrhythmia Section, Cardiology Department, Hospital Clínic and IDIBAPS (Institut d'Investigació Agustí Pi i Sunyer), Barcelona, Spain. Electronic address: berruezo@clinic.ub.es.
authors: Antonio
authors: A
authors: Berruezo
mesh_terms: D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac; D006801:Humans; D017180:Tachycardia, Ventricular / Q000601:surgery*
keywords: Catheter ablation; Substrate mapping; Ventricular tachycardia