Do the spatial characteristics of myocardial scar tissue determine the risk of ventricular arrhythmias?

Sudden cardiac death is one of the main causes of mortality in patients with structural heart disease. Although an implantable cardioverter de?brillator signi?cantly reduces the mortality rate, many patients never receive a shock. Identi?cation of high-risk patients would reduce the costs associated with this therapy and prevent the deleterious effect of inappropriate discharges. As scar tissue is the substrate of ventricular arrhythmias in patients with structural heart disease, scar characterization could allow strati?cation of the risk. The objective of this article is to review the role of scar characteristics in the pathogenesis of ventricular arrhythmias in patients with structural heart disease.

New diagnostic and therapeutic approaches to treat ventricular tachycardias originating at the summit of the left ventricle role of merged hemodynamic-MRI and alternative ablation sources

The left ventricular (LV) summit is the most common site of idiopathic epicardial LV arrhythmias and frequently represents a diagnostic and a therapeutic challenge.1 We present a case of sustained monomorphic ventricular tachycardia (SMVT) originating at the LV summit that underwent failed cryosurgical epicardial ablation and was successfully treated with the aid of merged hemodynamic and contrast-enhanced MRI (CE-MRI).