Wave Speed Mapping as a Complementary Tool for Identifying Ventricular Tachycardia Substrate

Area of Science:

• Electrophysiology
• Cardiac Mapping

Background:

• Wave speed (WS) mapping visualizes local conduction velocity (CV) in real-time using omnipolar technology.
• The clinical utility of WS mapping in ventricular tachycardia (VT) ablation requires further characterization.

Purpose of the Study:

• To evaluate the application of WS mapping in patients undergoing VT ablation.
• To compare WS mapping with established techniques like peak frequency (PF) and isochronal late activation mapping (ILAM).

Main Methods:

• A case series of patients undergoing VT ablation utilizing WS mapping alongside PF and ILAM.
• WS mapping data was analyzed for regions of high CV and conduction heterogeneity.
• Ablation strategies were guided by WS mapping findings.

Main Results:

• WS mapping identified regions of high CV and conduction heterogeneity, partially overlapping with PF and ILAM findings.
• WS mapping revealed broader or discordant zones compared to conventional markers in some cases.
• Ablation targeting WS-identified regions led to VT termination or noninducibility.

Conclusions:

• WS mapping may provide complementary information on conduction heterogeneity and mismatch in VT substrates.
• Preliminary findings suggest WS mapping could refine substrate-guided VT ablation.
• Further investigation is warranted, acknowledging limitations in functional validation.