The authors present a clinical and electrophysiological characteristic in two cases of symptomatic sustained ventricular tachycardia (VT) with a QRS morphology of left bundle branch block, refractory to common antiarrhythmic treatment. It was confirmed that the mechanism of this arrhythmia associated with a high risk of sudden death is the reentry phenomenon and the authors analyzed its relationship to arrhythmogenic dysplasia of the right ventricle. In a way uncommon in our literature the authors demonstrate the importance of comprehensive electrophysiological examination in these serious cases and its usefulness in confirming the origin of VT in the right ventricle, its importance for mapping the accurate localization of tachycardia and the investigation of effectiveness of drugs and the evaluation of aptness of non-pharmacological treatment.
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JACC Clin Electrophysiol
January 2025
Vanderbilt Heart and Vascular Institute, Nashville, Tennessee, USA. Electronic address:
Background: Programmed electrical stimulation (PES) is an essential part of ventricular tachycardia (VT) ablation procedures, but VT is not always inducible, usually for reasons that are not clear.
Objectives: This study sought to review pacing site-specific failure of PES to induce scar-related VT and to provide a potential mechanistic explanation of the phenomena using a computer simulation.
Methods: Six patients in whom aggressive PES from traditional RV pacing sites failed to induce VT, but VT was easily inducible from a nontraditional site, were reviewed.
JACC Clin Electrophysiol
January 2025
Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. Electronic address:
JACC Clin Electrophysiol
January 2025
Montreal Heart Institute, Montreal, Québec, Canada.
Background: Ventricular tachycardia (VT) substrate characteristics before transcatheter pulmonary valve replacement (TPVR) in repaired tetralogy of Fallot (rTOF) are unknown.
Objectives: In this study, the authors sought to evaluate substrates for sustained monomorphic VT before TPVR in rTOF.
Methods: Retrospective (2017 to 2021) and prospective (commencing 2021) rTOF patients with native right ventricular outflow tract referred for electrophysiology study (EPS) before TPVR were included.
JACC Clin Electrophysiol
January 2025
Section of Cardiac Pacing and Electrophysiology, Division of Cardiology, Cleveland Clinic, Cleveland, Ohio, USA.
Background: In patients with mechanical aortic and mitral valves requiring catheter ablation of ventricular tachycardia (VT), a technique for access from the right atrium (RA) to the left ventricle (LV) via puncture of the inferoseptal process of the LV was previously described in a single-center series.
Objectives: This study sought to report the multicenter experience of VT ablation using this novel LV access approach.
Methods: We assembled a multicenter registry of patients with double mechanical valves who underwent VT ablation with RA-to-LV access.
JACC Adv
December 2024
Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
Background: Risk stratification for sudden cardiac death (SCD) in patients with nonischemic cardiomyopathy (NICM) remains challenging.
Objectives: This study aimed to investigate the impact of epicardial adipose tissue (EAT) on SCD in NICM patients.
Methods: Our study cohort included 173 consecutive patients (age 53 ± 14 years, 73% men) scheduled for primary prevention implantable cardioverter-defibrillators (ICDs) implantation who underwent preimplant cardiovascular magnetic resonance.
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