Simultaneous endo-epicardial-high density mapping of ventricular tachycardia with the use of multi-electrode mapping catheters.

We herein describe a case of VT in an ischemic cardiomyopathy patient utilizing a novel technique of simultaneous endo-epicardial high-density mapping. Epicardial access, in addition to retrograde aortic endocardial access, was performed. Following the creation of the respective endocardial and epicardial electrical substrate maps, activation mapping of the VT was then performed simultaneously with two overlapping HD Grid catheters. Full diastolic pathway mapping was achieved, with EGMs recorded in all segments of the diastolic interval, on the epicardial surface. This case highlights the feasibility of a technique that can reliably detect the presence of activation bridges in a 3D model of VT.