Arrhythmias & electrophysiology
Feasibility and Safety of Strategic Multielectrode Positioning Guided by S3 Protocol for Hemodynamically Unstable Ventricular Tachycardia
- Analysis of consecutive patients undergoing scar-related ventricular tachycardia (VT) ablation
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
Main finding
As reported in the abstract
STaMP mapping success
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
Acute hemodynamic decompensation
- 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. JACC Clin Electrophysiol. Published 13 August 2026. doi:10.1016/j.jacep.2026.06.036
Summarised from the published abstract; every number is checked against it