EP Fellows Curriculum: Ischemic Cardiomyopathy and VT-EP Fellows Curriculum: Ischemic Cardiomyopathy and VT

Video Transcription

Video Summary

In this video, the speaker discusses various strategies for managing ventricular tachycardia (VT) in patients with structural heart disease, focusing on substrate-based ablation. The speaker emphasizes the importance of evaluating the underlying substrate and its characteristics, such as scar tissue distribution, for effective VT management. They explain that clinical VT can have different morphologies due to alternating exits from the same substrate, highlighting the need for comprehensive ablation to target all potential channels of conduction. The speaker also discusses the use of high-density mapping tools and other contemporary ablation techniques to improve the success of substrate-based ablation. They stress the importance of correctly identifying the VT substrate before the procedure and provide tips for inducing VT in cases where multiple VTs are present. They suggest modifying the substrate through ablation and pacing to demonstrate electrical inexcitability as potential strategies. The speaker concludes by mentioning that patients with non-ischemic heart disease may present with a mixed substrate and that comprehensive ablation may be necessary to effectively manage their VT.

Keywords

ventricular tachycardia

substrate-based ablation

structural heart disease

scar tissue distribution

comprehensive ablation

high-density mapping tools

inducing VT

modifying substrate

electrical inexcitability

non-ischemic heart disease