Electroanatomical Mapping at a Crossroads

摘要

Over the last decades, ventricular tachycardia ablation has evolved into an important therapeutic option for patients with structural heart disease (1). The development of electroanatomical mapping technologies has revolutionized the field, as it has allowed l to precisely localize the mapping catheter and record signals in a closed chest (2). In tolerated ventricular tachycardias, an activation map can identify critical sites of the reentrant circuit that can then be targeted with ablation. However, this is rarely accomplished, as the majority of ventricular tachycardias are not hemodynamically tolerated. This may be due to early coronary interventions for acute myocardial infarctions that produce more heterogenous infarcts with smaller circuits and shorter cycle lengths as well as due to small and patchy scars in patients with noni-s.chemic cardiomyopathy.