Indications for epicardial mapping of ventricular tachycardia (VT)
When do you consider epicardial mapping for ventricular tachycardia (VT)?
Mapping and ablation of ventricular tachycardia (VT) is usually done from the endocardial approach except in the following specific situations:
VT in structural heart diseases with a propensity for an epicardial substrate like Chagas disease and arrhythmogenic right ventricular cardiomyopathy (ARVC/ARVD)
Hyperenhancement seen in the epicardial region on contrast enhanced cardiac magnetic resonance (CMR) imaging
Endocardial mapping fails to identify an endocardial scar
Electrocardiographic features of clinical or induced VT indicating an epicardial focus
Failed attempt at ablation by endocardial approach
Reference
Fernandez-Armenta J et al. Substrate modification or ventricular tachycardia induction, mapping, and ablation as the first step? A randomized study. Heart Rhythm 2016;13:1589-1595.
Source: Cardiophile MD - Category: Cardiology Authors: Johnson Francis Tags: Cardiology ECG / Electrophysiology arrhythmogenic right ventricular cardiomyopathy ARVC ARVD Chagas disease Source Type: blogs
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