Papageorgiou Nikolaos, Srinivasan Neil T
Department of Cardiac Electrophysiology, Barts Heart Centre, St Bartholomew's Hospital, London, UK.
Institute of Cardiovascular Science, University College London, London, UK.
Arrhythm Electrophysiol Rev. 2021 Apr;10(1):38-44. doi: 10.15420/aer.2020.28.
Post-infarct-related ventricular tachycardia (VT) occurs due to reentry over surviving fibres within ventricular scar tissue. The mapping and ablation of patients in VT remains a challenge when VT is poorly tolerated and in cases in which VT is non-sustained or not inducible. Conventional substrate mapping techniques are limited by the ambiguity of substrate characterisation methods and the variety of mapping tools, which may record signals differently based on their bipolar spacing and electrode size. Real world data suggest that outcomes from VT ablation remain poor in terms of freedom from recurrent therapy using conventional techniques. Functional substrate mapping techniques, such as single extrastimulus protocol mapping, identify regions of unmasked delayed potentials, which, by nature of their dynamic and functional components, may play a critical role in sustaining VT. These methods may improve substrate mapping of VT, potentially making ablation safer and more reproducible, and thereby improving the outcomes. Further large-scale studies are needed.
梗死后相关室性心动过速（VT）是由于心室瘢痕组织内存活纤维的折返而发生的。当VT耐受性差以及VT非持续性或不可诱发时，对VT患者进行标测和消融仍然是一项挑战。传统的基质标测技术受到基质表征方法的模糊性和各种标测工具的限制，这些工具可能会根据其双极间距和电极大小不同地记录信号。现实世界的数据表明，就使用传统技术避免再次治疗而言，VT消融的结果仍然很差。功能性基质标测技术，如单期外刺激方案标测，可识别未掩盖的延迟电位区域，这些区域由于其动态和功能成分的性质，可能在维持VT中起关键作用。这些方法可能会改善VT的基质标测，有可能使消融更安全、更可重复，从而改善结果。还需要进一步的大规模研究。
