Advances in Mapping and Catheter Ablation of Ventricular Arrhythmias in Ischemic and Scar-related Substrates

Ransford S. Brenya, Deepak Bhakta, John Miller

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Ventricular tachycardia (VT) in patients with prior myocardial damage is generally related to propagation of impulses through surviving myocardial bundles surrounded by and insulated from other fibers by scar tissue. Recurrent VT in these patients is problematic in that, while implantable cardioverter-defibrillators effectively prevent sudden death, they do so at the expense of painful shocks; this, and the fact that medications are generally unsatisfactory at preventing VT episodes in many patients creates a growing need for alternative therapies. Catheter ablation of VT in these patients can be difficult due to varying degrees of hemodynamic compromise during VT as well as the presence of multiple morphologies of VT in most patients and difficulty interpreting complex electrograms during VT. Because of these problems, substrate mapping and ablation (whereby an ablation strategy can be developed without the having the patient spend large amounts of time in VT for detailed mapping of the course of impulse propagation) have assumed an increasingly important role in managing these patients. This chapter explores the pathophysiology of scar-based VT in a variety of substrates and how mapping and ablation strategies based on that information can be tailored to the particular patient's circumstances to obtain optimal results. This edition first published 2013

Original languageEnglish
Title of host publicationCardiac Mapping: Fourth Edition
PublisherWiley-Blackwell
Pages439-449
Number of pages11
ISBN (Print)9780470670460
DOIs
StatePublished - Dec 18 2012

Fingerprint

Catheter Ablation
Ventricular Tachycardia
Cicatrix
Cardiac Arrhythmias
Implantable Defibrillators
Complementary Therapies
Sudden Death
Shock
Hemodynamics

Keywords

  • Scar mapping
  • Scar-based VT
  • Substrate mapping

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Advances in Mapping and Catheter Ablation of Ventricular Arrhythmias in Ischemic and Scar-related Substrates. / Brenya, Ransford S.; Bhakta, Deepak; Miller, John.

Cardiac Mapping: Fourth Edition. Wiley-Blackwell, 2012. p. 439-449.

Research output: Chapter in Book/Report/Conference proceedingChapter

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