Arrhythmias & electrophysiology
Feasibility and Safety of Strategic Multielectrode Positioning Guided by S3 Protocol for Hemodynamically Unstable Ventricular Tachycardia: The S3-STaMP Project
Authors' conclusion
STaMP mapping is feasible, rapid, and safe for identifying critical diastolic pathways in nontolerated VT. Integration of S3 functional mapping enhances diagnostic yield, supporting STaMP as a pragmatic tool to refine substrate-guided VT ablation.
Study context
- Population
- Patients undergoing scar-related VT ablation with unstable VT
- Participants
- 30 consecutive patients
- Outcome
- STaMP mapping success
Main finding
As reported in the abstract
Strategic Multielectrode Positioning (STaMP) mapping successful
22 of 30 patients
73%
Full diastolic pathway delineated
60%
Further findings
Mapping time
- Mean mapping time
- 20 ± 12 seconds
- STaMP-positive vs other patients
- 14 seconds vs 34.5 seconds; P = 0.003
Features associated with STaMP positivity
- Shorter mapping time
- OR: 0.88; P = 0.009
- Slower conduction in the deceleration zone identified on the S3 map
- OR: 1.04; P = 0.048
- Presence of magnetic resonance imaging conducting channels
- OR: 16.7; P = 0.007
Additional STaMP-positive zones revealed by S3 protocol
- Patients with additional STaMP-positive zones
- 27%
VT recurrence · median follow-up of 19 months
- VT recurrence
- 23%
- No difference between groups
- log-rank P = 0.20
Safety
- Patients at high PAINESD risk
- 16
- No acute hemodynamic decompensation occurred
Original publication
Feasibility and Safety of Strategic Multielectrode Positioning Guided by S3 Protocol for Hemodynamically Unstable Ventricular Tachycardia: The S3-STaMP Project. JACC Clin Electrophysiol. Published 13 August 2026. doi:10.
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