Session II: Invasive Diagnosis and Treatment-6154-Principles of Entrainment- Ventricular Tachycardia

Video Transcription

Video Summary

This video discusses the principles of entrainment for ventricular tachycardia (VT) mapping. The speaker explains how activation maps created with modern electroanatomic mapping can show examples of reentry circuits in scar-related reentry. The reentry circuits often take the form of a double loop or figure-eight circuit, with a wavefront emerging from an isthmus and propagating in counterclockwise and clockwise directions around the isthmus. These circuits form in areas of scar. Entrainment mapping allows clinicians to recognize parts of the reentry circuit and determine if the site is at a narrow isthmus where ablation can effectively interrupt the VT. The post-pacing interval, which reflects the conduction time to and from the circuit, can help assess the proximity of the pacing site to the reentry circuit. Fusion, which is a reflection of how the stimulated antidromic wavefronts can propagate away from the pacing site, can distinguish an outer loop site from an isthmus site. The speaker emphasizes that entrainment mapping is complementary to activation mapping and can be a powerful tool in guiding ablation of scar-related reentrant arrhythmias.

Keywords

ventricular tachycardia

entrainment mapping

activation mapping

reentry circuits

scar-related reentry

double loop circuit

figure-eight circuit

ablation