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This review provides insights into mapping and ablation strategies for VT, offering a comprehensive overview of contemporary approaches and future perspectives in the field. The strengths and limitations of classical mapping strategies, namely activation mapping, pace mapping, entrainment mapping, and substrate mapping, are deeply discussed. The increasing pivotal relevance of CMR and MDCT in substrate definition is highlighted, particularly in defining the border zone, tissue channels, and fat. The integration of CMR and MDCT images with EAM is explored, with a special focus on their role in enhancing effectiveness and procedure safety. The abstract concludes by illustrating the Pisa workflow for the VT ablation procedure.
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http://dx.doi.org/10.3390/jcm13175017 | DOI Listing |
Eur Heart J Case Rep
September 2025
Clinical Electrophysiology, St. Joseph's Heart Rhythm Center, Anny Jagiellonki 17, 35-623 Rzeszów, Poland.
Background: Premature ventricular contractions (PVCs) originating from the infundibular region of the right ventricular outflow tract (RVOT) may be challenging to ablate due to thin myocardial wall and proximity to the coronary arteries in this region. In such anatomically sensitive regions, the use of radiofrequency (RF) energy may carry a risk of collateral injury or prove ineffective. We present a case report describing successful ablation of infundibular PVCs using pulsed field ablation (PFA).
View Article and Find Full Text PDFHeart Rhythm O2
August 2025
Cardiac Electrophysiology Section, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Background: Cardiac amyloidosis (CA) is characterized by atrial myopathy, which predisposes patients to atrial fibrillation (AF) and other atrial arrhythmias (AA). Although catheter ablation of AA is effective in the general population, its efficacy and safety in patients with CA remain unclear.
Objective: The study aimed to evaluate outcomes in patients with CA undergoing catheter ablation for typical atrial flutter (TAFL) and left atrial (LA) arrhythmias and to assess the presence and influence of LA low-voltage areas (LVA) in the latter.
Heart Rhythm O2
August 2025
Division of Cardiology, Tokyo Metropolitan Ohkubo Hospital, Shinjyuku-ku, Tokyo, Japan.
Background: Various methods have been devised for catheter ablation of persistent atrial fibrillation (AF). However, it remains difficult to understand the mechanism of AF and to determine the optimal method.
Objective: This study aimed to evaluate the effectiveness of rotor modification (RM) compared to posterior wall isolation (PWI) in the treatment of persistent AF.
Heart Rhythm O2
August 2025
National Heart and Lung Institute, Imperial College London, London, United Kingdom.
Background: Adjunctive posterior wall isolation (PWI) to pulmonary vein isolation (PVI) has not demonstrated convincing benefit during atrial fibrillation (AF) ablation. To provide mechanistic insight for null PWI trials, we undertook Granger causality (GC) analysis of noncontact left atrial (LA) electroanatomic maps.
Objective: This study aimed to apply GC to intracardiac electrograms to uncover patient-specific AF dynamics and describe a proof-of-concept approach to targeted PWI after PVI.
J Cardiovasc Electrophysiol
September 2025
Department of Cardiology, Second Affiliated Hospital of Third Military Medical University (Army Medical University), Chongqing, China.
Background And Aims: Ablation for premature ventricular complexes (PVCs) originating from the right ventricular inflow tract (RVIT) is challenging. Few studies have identified the correlation between right ventricular false tendons (RVFTs) and RVIT PVCs. This study aimed to verify RVFTs as arrhythmogenic and electro-anatomical substrates for PVCs, and propose an enlightening mapping and ablation protocol to improve operative efficacy.
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