Substrate Mapping for Ablation of Ventricular Tachycardia in Coronary Artery Disease

Ventricular tachycardia occurs in patients with myocardial scar resulting from coronary artery disease. Endocardial catheter mapping and ablation has become an accepted therapy for patients with recurrent ventricular tachycardia. Traditional entrainment and pace-mapping techniques have limitations and may not be useful in some patients. Substrate mapping guided by intracardiac electrograms and 3-D electroanatomic mapping systems allows the identification of myocardial scar. Potential sites of reentrant circuits may be identified and targeted for linear ablation lesions. This technique has been shown to be effective in selected patients for preventing recurrent VT and ICD shocks.