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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Published on: January 31, 2019

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Geometric Features of Ventricular Tachycardia Corridors in Patients With Ischemic Cardiomyopathy

Lingyu Xu1, Stanislau Hrybouski2, Ting-Wei Ernie Liao1

  • 1Cardiovascular Medicine Division (L.X., T.-W.E.L., M.K., D.J.C., F.E.M., S.N.), University of Pennsylvania, Philadelphia.

Circulation
|October 29, 2025
PubMed

Insights

Most ventricular tachycardia (VT) corridors in ischemic cardiomyopathy patients are hyperboloid in shape. These viable myocardial pathways, identified using cardiac MRI, show a wider opening at the VT exit than the entrance.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Electrophysiology

Background:

  • Ventricular tachycardia (VT) circuitry is often complex in ischemic cardiomyopathy.
  • A 3D hyperboloid model has been proposed for VT characterization.
  • Geometric features of viable myocardial corridors are crucial for understanding VT.

Purpose of the Study:

  • To characterize the geometric features of viable myocardial corridors in ischemic cardiomyopathy.
  • To correlate these features with late gadolinium-enhanced cardiovascular magnetic resonance (LGE-CMR) findings.
  • To validate LGE-CMR derived geometry with electrophysiological mapping data.

Main Methods:

  • Retrospective analysis of 46 ischemic cardiomyopathy patients undergoing LGE-CMR before VT ablation.
  • Coregistration of viable corridors on LGE-CMR with VT exit/entrance sites from entrainment/pace mapping.
  • Measurement of corridor geometry (hyperboloid, funnel, cylinder), ostium angle, width, length, thickness, volume, and accessibility.

Main Results:

  • Of 125 VT exit sites, 93.6% of central corridors were hyperboloid, with 4.8% funnel and 1.6% cylinder.
  • All 11 VT entrance sites analyzed showed hyperboloid central corridors.
  • The mean VT exit ostium angle (102.8°) was significantly larger than the entrance ostium angle (83.2°).

Conclusions:

  • VT corridors in ischemic cardiomyopathy predominantly exhibit hyperboloid geometry.
  • Funnel and cylinder geometries are less common but present.
  • The hyperboloid shape features a wider opening at the VT exit compared to the entrance, impacting circuit dynamics.
Abstract

Keywords:
cardiomyopathiesinfarctionmagnetic resonance imagingventricular tachycardia

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