Catheter ablation of ventricular tachycardia guided by noncontact mapping

Catheter ablation of untolerated and unstable ventricular tachycardia may not be performed using a conventional activation mapping tecnique. The noncontact mapping system enables reconstruction of the spreading of activation wave through a virtually generated ventricular chamber, even from a single tachycardia beat, and was introduced as a tool to guide mapping and ablation of untolerated or unsustained ventricular arrhythmias. The reduced accuracy in the setting of enlarged ventricles is recognized as the main limitation of this tecnique. While noncontract mapping appears to be especially suitable in guiding the ablation of unsustained idiopathic ventricular arrhythmias, it can also be successfully used as a guide to perform ablation of untolerated re-entry-related ventricular tachycardias during sinus rhythm.