Arrhythmias & electrophysiology
Functional Substrate Mapping and Its Correlation With Ventricular Tachycardia Critical Sites: A Blinded Study
Authors' conclusion
In a blinded evaluation, areas of decremental conduction identified by functional substrate mapping showed a high degree of colocalization with VT critical sites, particularly in ICM patients. This relationship was less consistent in NICM patients.
Study context
- Population
- Patients with structural heart disease undergoing ventricular tachycardia (VT) ablationAmong 33 patients who underwent the extra-stimulus protocol, 20 completed mapping and had inducible VT, 51 VTs
- Participants
- 20 patients
- Comparison
- correlation between areas of decremental conduction unveiled with functional substrate mapping and VT critical sites identified using traditional substrate mapping
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Colocalization of putative isthmi or breakthrough sites with decremental conduction regions
10-milliseconds cutoff
78%
20-milliseconds cutoff
73%
Further findings
Colocalization rate, ICM vs NICM · higher in ICM
10-ms
20-ms
- Colocalization rate, ICM vs nonischemic cardiomyopathy (NICM): P < 0.01 for 10-ms
- Colocalization rate, ICM vs NICM: P = 0.03 for 20-ms
Decremental area size, 20-milliseconds vs 10-milliseconds threshold
- The 20-milliseconds decremental area was smaller
- P < 0.01
Baseline characteristics
- Mean age
- 62 [IQR: 54-73] years
- Ischemic cardiomyopathy
- 55%
Original publication
Functional Substrate Mapping and Its Correlation With Ventricular Tachycardia Critical Sites: A Blinded Study. JACC Clin Electrophysiol. Published 7 August 2026. doi:10.
Summarised from the published abstract; every number is checked against it