{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:46:36Z","timestamp":1762508796820,"version":"3.41.2"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Substrate-based ablation has become a successful technique for ventricular tachycardia (VT) ablation. High-density (HD) mapping catheters provide high-resolution electroanatomical maps and better discrimination of local abnormal electrograms. The HD Grid Mapping Catheter is an HD catheter with the ability to map orthogonal signals on top of conventional bipolar signals, which could provide better discrimination of the arrhythmic substrate. On the other hand, conventional mapping techniques, such as activation mapping, when possible, help to identify the isthmus of the tachycardia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The purpose of this study was to compare clinical outcomes after using two different VT ablation strategies: one based on extensive mapping with the HD Grid Mapping Catheter, including VT isthmus analysis, and the other based on pure substrate ablation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty consecutive patients undergoing VT ablation with extensive HD mapping method in the hospital clinic (November 2018\u2013November 2019) were included. Clinical outcomes were compared with a historical cohort of 26 consecutive patients who underwent ablation using a scar dechanneling technique before 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The density of mapping points was higher in the extensive mapping group (2370.24 \u00b1 920.78 vs. 576.45 \u00b1 294.46; <jats:italic>p<\/jats:italic> &amp;lt; 0.001). After 1 year of follow-up, VT recurred in 18.4% of patients in the extensive mapping group vs. 34.6% of patients in the historical control group (<jats:italic>p<\/jats:italic> = 0.14), with a significantly greater reduction of VT burden: VT episodes (81.7 \u00b1 7.79 vs. 43.4 \u00b1 19.9%, <jats:italic>p<\/jats:italic> &amp;lt; 0.05), antitachycardia pacing (99.45 \u00b1 2.29 vs. 33.9 \u00b1 102.5%, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), and implantable cardioverter defibrillator (ICD) shocks (99 \u00b1 4.5 vs. 64.7 \u00b1 59.9%, <jats:italic>p<\/jats:italic> = 0.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of a method based on extensive mapping with the HD Grid Mapping Catheter and VT isthmus analysis allows better discrimination of the arrhythmic substrate and could be associated with a greater decrease in VT burden.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.912335","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T05:29:10Z","timestamp":1659331750000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Orthogonal high-density mapping with ventricular tachycardia isthmus analysis vs. pure substrate ventricular tachycardia ablation: A case\u2013control 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