Repolarization and Activation Mapping in Ventricular Tachycardia Ablation: The REDEEM Study.
Luigi Pannone1, Antonio Bisignani2, Pietro Rossi3
1Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Heart Rhythm Research Brussels, Postgraduate Program in Cardiac Electrophysiology and Pacing, Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium.
JACC. Clinical Electrophysiology
|June 26, 2026
Summary
A new repolarization-depolarization mapping (REDEEM) method shows promise for identifying ventricular tachycardia (VT) ablation sites. This approach correlates well with critical isthmus locations, aiding VT substrate characterization.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Imaging
Background:
- Ventricular tachycardia (VT) ablation relies on effective substrate mapping during sinus rhythm.
- Existing mapping strategies have limitations in precisely identifying critical VT circuits.
Purpose of the Study:
- To evaluate a novel sinus rhythm mapping technique, repolarization-depolarization mapping (REDEEM), for identifying VT isthmus sites.
- To assess the association between REDEEM-identified features and anatomical VT substrate.
Main Methods:
- Retrospective analysis of 20 patients undergoing VT ablation.
- Utilized local activation time (LAT) mapping (LATlatest) and unipolar repolarization mapping (Wyatt method).
- Defined deceleration zones (DZs) and repolarization cliffs based on specific criteria.
Main Results:
- REDEEM identified critical anatomical associations with VT isthmus sites in all cases.
- Repolarization cliffs overlapped with VT exit sites (100%) and diastolic channels.
- Deceleration zones were associated with VT entrance sites (90%) and mid-isthmus regions (95%).
Conclusions:
- The REDEEM method is feasible for VT substrate mapping during sinus rhythm.
- REDEEM demonstrates significant anatomical correlations with VT isthmus locations.
- These findings provide mechanistic insights warranting further prospective validation.
