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Polarity Behavior of Decrement-Evoked Potentials in Functional Substrate Mapping of Ventricular Tachycardia
Taro Temma1, Masaya Watanabe1,2, Hisashi Yokoshiki3
1Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Introduction:
Decrement-evoked potentials (DEEPs) are used to identify the functional substrate during ventricular tachycardia (VT) ablation, but distinguishing arrhythmogenic from bystander DEEPs remains challenging.
Methods And Results:
During substrate-based VT ablation, DEEPs were analyzed using a predefined early evaluation window and dominant initial deflection during S1 pacing and S2 extrastimulus. DEEPs exhibiting polarity change between S1 and S2 were observed at the critical ablation site, whereas DEEPs without polarity change were found at non-critical sites. Ablation at the polarity-changing DEEP site was effective.
Conclusion:
DEEP polarity behavior may help differentiate critical VT substrate from bystander regions.
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