Arrhythmias & electrophysiologyResearch article
Functional Substrate Mapping and Its Correlation With Ventricular Tachycardia Critical Sites
- blinded study
- consecutive patients
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
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. JACC Clin Electrophysiol. Published 7 August 2026. doi:10.1016/j.jacep.2026.07.005
Summarised from the published abstract; every number is checked against it