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MINERVA CARDIOANGIOLOGICA

A Journal on Heart and Vascular Diseases


Official Journal of the Italian Society of Angiology and Vascular Pathology
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Minerva Cardioangiologica 2017 Apr 12

DOI: 10.23736/S0026-4725.17.04402-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Off-line analysis of electro-anatomical mapping in ventricular arrhythmias

Daniele MUSER, Jackson J. LIANG, Pasquale SANTANGELI

Cardiac Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA


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Sudden cardiac death due to ventricular tachycardia (VT) is a major health issue in patients with structural heart
disease and depressed ejection fraction. If from one side, implantable cardioverter defibrillator (ICD) therapy has
significantly improved survival of these patients, on the other hand, it has led to frequent ICD shocks as an
emerging problem, being associated with poor quality of life, frequent hospitalizations and increased mortality.
Scar-related reentry due to the coexistence of surviving myocardial fibers within fibrotic tissue is the most
common mechanism subtending VT both in ischemic and non-ischemic cardiomyopathies. In the last two
decades, continuous efforts to determine VT mechanisms and effectively prevent and treat VT with a substratebased
approach has benefit from off-line analysis of data coming from invasive electroanatomical mapping as
well as from noninvasive imaging modalities such as cardiac magnetic resonance able to identify the arrhythmic
substrate. In this review, we walk over again established methods for VT substrate characterization and we
present possible applications of new emerging technologies.


KEY WORDS: Ventricular tachycardia - Electroanatomical mapping - Catheter ablation - Substrate characterization

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pasquale.santangeli@uphs.upenn.edu