Dynamic Voltage Mapping of the Post-infarct Ventricular Tachycardia Substrate: A Practical Technique to Help Differentiate Scar from Borderzone Tissue
During catheter ablation of post-infarct ventricular tachycardia (VT), substrate mapping is used when VT is non-inducible or poorly tolerated. Substrate mapping aims to identify regions of slowly conducting myocardium (borderzone) within and surrounding myocardial scar for ablation. Historically, th...
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| Format: | Article |
| Language: | English |
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Radcliffe Medical Media
2024-10-01
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| Series: | Arrhythmia & Electrophysiology Review |
| Online Access: | https://www.aerjournal.com/articleindex/aer.2024.26 |
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| author | Mark T Mills Peter Calvert Justin Chiong Dhiraj Gupta Vishal Luther |
| author_facet | Mark T Mills Peter Calvert Justin Chiong Dhiraj Gupta Vishal Luther |
| author_sort | Mark T Mills |
| collection | DOAJ |
| description | During catheter ablation of post-infarct ventricular tachycardia (VT), substrate mapping is used when VT is non-inducible or poorly tolerated. Substrate mapping aims to identify regions of slowly conducting myocardium (borderzone) within and surrounding myocardial scar for ablation. Historically, these tissue types have been identified using bipolar voltage mapping, with areas of low bipolar voltage (<0.50 mV) defined as scar, and areas with voltages between 0.50 mV and 1.50 mV as borderzone. In the era of high-density mapping, studies have demonstrated slow conduction within areas of bipolar voltage <0.50 mV, suggesting that this historical cut-off is outdated. While electrophysiologists often adapt voltage cut-offs to account for this, the optimal scar-borderzone threshold is not known. In this review, we discuss dynamic voltage mapping, a novel substrate mapping technique we have developed, which superimposes data from both activation and voltage maps, to help delineate the post-infarct VT circuit through identification of the optimal scar-borderzone voltage threshold. |
| format | Article |
| id | doaj-art-48bdcb6f198a4e109d5d163b4fc5752d |
| institution | OA Journals |
| issn | 2050-3369 2050-3377 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | Arrhythmia & Electrophysiology Review |
| spelling | doaj-art-48bdcb6f198a4e109d5d163b4fc5752d2025-08-20T02:37:51ZengRadcliffe Medical MediaArrhythmia & Electrophysiology Review2050-33692050-33772024-10-011310.15420/aer.2024.26Dynamic Voltage Mapping of the Post-infarct Ventricular Tachycardia Substrate: A Practical Technique to Help Differentiate Scar from Borderzone TissueMark T Mills0Peter Calvert1Justin Chiong2Dhiraj Gupta3Vishal Luther4Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK; Department of Cardiology, Liverpool Heart & Chest Hospital NHS Foundation Trust, Liverpool, UK.Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK; Department of Cardiology, Liverpool Heart & Chest Hospital NHS Foundation Trust, Liverpool, UK.epartment of Cardiology, Liverpool Heart & Chest Hospital NHS Foundation Trust, Liverpool, UK.Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK; Department of Cardiology, Liverpool Heart & Chest Hospital NHS Foundation Trust, Liverpool, UK.Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK; Department of Cardiology, Liverpool Heart & Chest Hospital NHS Foundation Trust, Liverpool, UK.During catheter ablation of post-infarct ventricular tachycardia (VT), substrate mapping is used when VT is non-inducible or poorly tolerated. Substrate mapping aims to identify regions of slowly conducting myocardium (borderzone) within and surrounding myocardial scar for ablation. Historically, these tissue types have been identified using bipolar voltage mapping, with areas of low bipolar voltage (<0.50 mV) defined as scar, and areas with voltages between 0.50 mV and 1.50 mV as borderzone. In the era of high-density mapping, studies have demonstrated slow conduction within areas of bipolar voltage <0.50 mV, suggesting that this historical cut-off is outdated. While electrophysiologists often adapt voltage cut-offs to account for this, the optimal scar-borderzone threshold is not known. In this review, we discuss dynamic voltage mapping, a novel substrate mapping technique we have developed, which superimposes data from both activation and voltage maps, to help delineate the post-infarct VT circuit through identification of the optimal scar-borderzone voltage threshold.https://www.aerjournal.com/articleindex/aer.2024.26 |
| spellingShingle | Mark T Mills Peter Calvert Justin Chiong Dhiraj Gupta Vishal Luther Dynamic Voltage Mapping of the Post-infarct Ventricular Tachycardia Substrate: A Practical Technique to Help Differentiate Scar from Borderzone Tissue Arrhythmia & Electrophysiology Review |
| title | Dynamic Voltage Mapping of the Post-infarct Ventricular Tachycardia Substrate: A Practical Technique to Help Differentiate Scar from Borderzone Tissue |
| title_full | Dynamic Voltage Mapping of the Post-infarct Ventricular Tachycardia Substrate: A Practical Technique to Help Differentiate Scar from Borderzone Tissue |
| title_fullStr | Dynamic Voltage Mapping of the Post-infarct Ventricular Tachycardia Substrate: A Practical Technique to Help Differentiate Scar from Borderzone Tissue |
| title_full_unstemmed | Dynamic Voltage Mapping of the Post-infarct Ventricular Tachycardia Substrate: A Practical Technique to Help Differentiate Scar from Borderzone Tissue |
| title_short | Dynamic Voltage Mapping of the Post-infarct Ventricular Tachycardia Substrate: A Practical Technique to Help Differentiate Scar from Borderzone Tissue |
| title_sort | dynamic voltage mapping of the post infarct ventricular tachycardia substrate a practical technique to help differentiate scar from borderzone tissue |
| url | https://www.aerjournal.com/articleindex/aer.2024.26 |
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