Advertisement

Ventricular Tachycardia in Ischemic Heart Disease

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Cardiac Electrophysiology Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Moss A.J.
        • Greenberg H.
        • Case R.B.
        • et al.
        Long-term clinical course of patients after termination of ventricular tachyarrhythmia by an implanted defibrillator.
        Circulation. 2004; 110: 3760-3765
        • Sears Jr., S.F.
        • Conti J.B.
        Quality of life and psychological functioning of ICD patients.
        Heart. 2002; 87: 488-493
        • Poole J.E.
        • Johnson G.W.
        • Hellkamp A.S.
        • et al.
        Prognostic importance of defibrillator shocks in patients with heart failure.
        N Engl J Med. 2008; 359: 1009-1017
        • Santangeli P.
        • Muser D.
        • Maeda S.
        • et al.
        Comparative effectiveness of antiarrhythmic drugs and catheter ablation for the prevention of recurrent ventricular tachycardia in patients with implantable cardioverter-defibrillators: a systematic review and meta-analysis of randomized controlled trials.
        Heart Rhythm. 2016; 13: 1552-1559
        • Palaniswamy C.
        • Kolte D.
        • Harikrishnan P.
        • et al.
        Catheter ablation of postinfarction ventricular tachycardia: ten-year trends in utilization, in-hospital complications, and in-hospital mortality in the United States.
        Heart Rhythm. 2014; 11: 2056-2063
        • Aliot E.M.
        • Stevenson W.G.
        • Almendral-Garrote J.M.
        • et al.
        EHRA/HRS expert consensus on catheter ablation of ventricular arrhythmias: developed in a partnership with the European heart rhythm association (EHRA), a registered branch of the European Society of Cardiology (ESC), and the Heart Rhythm Society (HRS); in collaboration with the American College of Cardiology (ACC) and the American Heart Association (AHA).
        Heart Rhythm. 2009; 6: 886-933
        • Go A.S.
        • Mozaffarian D.
        • Roger V.L.
        • et al.
        Heart disease and stroke statistics–2014 update: a report from the American Heart Association.
        Circulation. 2014; 129: e28-e292
        • Newby K.H.
        • Thompson T.
        • Stebbins A.
        • et al.
        Sustained ventricular arrhythmias in patients receiving thrombolytic therapy: incidence and outcomes. The GUSTO Investigators.
        Circulation. 1998; 98: 2567-2573
        • Tofler G.H.
        • Stone P.H.
        • Muller J.E.
        • et al.
        Prognosis after cardiac arrest due to ventricular tachycardia or ventricular fibrillation associated with acute myocardial infarction (the MILIS Study). Multicenter Investigation of the Limitation of Infarct Size.
        Am J Cardiol. 1987; 60: 755-761
        • Stevenson W.G.
        • Soejima K.
        Catheter ablation for ventricular tachycardia.
        Circulation. 2007; 115: 2750-2760
        • Buxton A.E.
        • Lee K.L.
        • Fisher J.D.
        • et al.
        A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators.
        N Engl J Med. 1999; 341: 1882-1890
        • Bloch Thomsen P.E.
        • Jons C.
        • Raatikainen M.J.
        • et al.
        Long-term recording of cardiac arrhythmias with an implantable cardiac monitor in patients with reduced ejection fraction after acute myocardial infarction: the Cardiac Arrhythmias and Risk Stratification after Acute Myocardial Infarction (CARISMA) study.
        Circulation. 2010; 122: 1258-1264
        • Berger C.J.
        • Murabito J.M.
        • Evans J.C.
        • et al.
        Prognosis after first myocardial infarction. Comparison of Q-wave and non-Q-wave myocardial infarction in the Framingham Heart Study.
        JAMA. 1992; 268: 1545-1551
        • Solomon S.D.
        • Zelenkofske S.
        • McMurray J.J.
        • et al.
        Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure, or both.
        N Engl J Med. 2005; 352: 2581-2588
        • Wijnmaalen A.P.
        • Schalij M.J.
        • von der Thusen J.H.
        • et al.
        Early reperfusion during acute myocardial infarction affects ventricular tachycardia characteristics and the chronic electroanatomic and histological substrate.
        Circulation. 2010; 121: 1887-1895
        • Piers S.R.
        • Wijnmaalen A.P.
        • Borleffs C.J.
        • et al.
        Early reperfusion therapy affects inducibility, cycle length, and occurrence of ventricular tachycardia late after myocardial infarction.
        Circ Arrhythm Electrophysiol. 2011; 4: 195-201
        • Friedman P.L.
        • Fenoglio J.J.
        • Wit A.L.
        Time course for reversal of electrophysiological and ultrastructural abnormalities in subendocardial Purkinje fibers surviving extensive myocardial infarction in dogs.
        Circ Res. 1975; 36: 127-144
        • Fenoglio Jr., J.J.
        • Pham T.D.
        • Harken A.H.
        • et al.
        Recurrent sustained ventricular tachycardia: structure and ultrastructure of subendocardial regions in which tachycardia originates.
        Circulation. 1983; 68: 518-533
        • de Bakker J.M.
        • van Capelle F.J.
        • Janse M.J.
        • et al.
        Slow conduction in the infarcted human heart. 'Zigzag' course of activation.
        Circulation. 1993; 88: 915-926
        • Rutherford S.L.
        • Trew M.L.
        • Sands G.B.
        • et al.
        High-resolution 3-dimensional reconstruction of the infarct border zone: impact of structural remodeling on electrical activation.
        Circ Res. 2012; 111: 301-311
        • Gardner P.I.
        • Ursell P.C.
        • Fenoglio Jr., J.J.
        • et al.
        Electrophysiologic and anatomic basis for fractionated electrograms recorded from healed myocardial infarcts.
        Circulation. 1985; 72: 596-611
        • Miller J.M.
        • Marchlinski F.E.
        • Buxton A.E.
        • et al.
        Relationship between the 12-lead electrocardiogram during ventricular tachycardia and endocardial site of origin in patients with coronary artery disease.
        Circulation. 1988; 77: 759-766
        • Park K.M.
        • Nam G.B.
        • Choi K.J.
        • et al.
        Recurrent polymorphic ventricular tachycardia treated by ablation of Purkinje arborization within an infarct border-zone.
        Tex Heart Inst J. 2011; 38: 291-294
        • Bogun F.
        • Good E.
        • Reich S.
        • et al.
        Role of Purkinje fibers in post-infarction ventricular tachycardia.
        J Am Coll Cardiol. 2006; 48: 2500-2507
        • Miller J.M.
        • Kienzle M.G.
        • Harken A.H.
        • et al.
        Morphologically distinct sustained ventricular tachycardias in coronary artery disease: significance and surgical results.
        J Am Coll Cardiol. 1984; 4: 1073-1079
        • Costeas C.
        • Peters N.S.
        • Waldecker B.
        • et al.
        Mechanisms causing sustained ventricular tachycardia with multiple QRS morphologies: results of mapping studies in the infarcted canine heart.
        Circulation. 1997; 96: 3721-3731
        • Yokokawa M.
        • Desjardins B.
        • Crawford T.
        • et al.
        Reasons for recurrent ventricular tachycardia after catheter ablation of post-infarction ventricular tachycardia.
        J Am Coll Cardiol. 2013; 61: 66-73
        • Bogun F.
        • Hohnloser S.H.
        • Bender B.
        • et al.
        Mechanism of ventricular tachycardia termination by pacing at left ventricular sites in patients with coronary artery disease.
        J Interv Card Electrophysiol. 2002; 6: 35-41
        • Valles E.
        • Bazan V.
        • Marchlinski F.E.
        ECG criteria to identify epicardial ventricular tachycardia in nonischemic cardiomyopathy.
        Circ Arrhythm Electrophysiol. 2010; 3: 63-71
        • Berruezo A.
        • Mont L.
        • Nava S.
        • et al.
        Electrocardiographic recognition of the epicardial origin of ventricular tachycardias.
        Circulation. 2004; 109: 1842-1847
        • Daniels D.V.
        • Lu Y.Y.
        • Morton J.B.
        • et al.
        Idiopathic epicardial left ventricular tachycardia originating remote from the sinus of Valsalva: electrophysiological characteristics, catheter ablation, and identification from the 12-lead electrocardiogram.
        Circulation. 2006; 113: 1659-1666
        • Yoshida K.
        • Liu T.Y.
        • Scott C.
        • et al.
        The value of defibrillator electrograms for recognition of clinical ventricular tachycardias and for pace mapping of post-infarction ventricular tachycardia.
        J Am Coll Cardiol. 2010; 56: 969-979
        • Vaseghi M.
        • Macias C.
        • Tung R.
        • et al.
        Percutaneous interventricular septal access in a patient with aortic and mitral mechanical valves: a novel technique for catheter ablation of ventricular tachycardia.
        Heart Rhythm. 2013; 10: 1069-1073
        • McCrohon J.A.
        • Moon J.C.
        • Prasad S.K.
        • et al.
        Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance.
        Circulation. 2003; 108: 54-59
        • Roes S.D.
        • Borleffs C.J.
        • van der Geest R.J.
        • et al.
        Infarct tissue heterogeneity assessed with contrast-enhanced MRI predicts spontaneous ventricular arrhythmia in patients with ischemic cardiomyopathy and implantable cardioverter-defibrillator.
        Circ Cardiovasc Imaging. 2009; 2: 183-190
        • Estner H.L.
        • Zviman M.M.
        • Herzka D.
        • et al.
        The critical isthmus sites of ischemic ventricular tachycardia are in zones of tissue heterogeneity, visualized by magnetic resonance imaging.
        Heart Rhythm. 2011; 8: 1942-1949
        • Cochet H.
        • Komatsu Y.
        • Sacher F.
        • et al.
        Integration of merged delayed-enhanced magnetic resonance imaging and multidetector computed tomography for the guidance of ventricular tachycardia ablation: a pilot study.
        J Cardiovasc Electrophysiol. 2013; 24: 419-426
        • Komatsu Y.
        • Cochet H.
        • Jadidi A.
        • et al.
        Regional myocardial wall thinning at multidetector computed tomography correlates to arrhythmogenic substrate in postinfarction ventricular tachycardia: assessment of structural and electrical substrate.
        Circ Arrhythm Electrophysiol. 2013; 6: 342-350
        • Zeppenfeld K.
        • Tops L.F.
        • Bax J.J.
        • et al.
        Images in cardiovascular medicine. Epicardial radiofrequency catheter ablation of ventricular tachycardia in the vicinity of coronary arteries is facilitated by fusion of 3-dimensional electroanatomical mapping with multislice computed tomography.
        Circulation. 2006; 114: e51-e52
        • Nakahara S.
        • Tung R.
        • Ramirez R.J.
        • et al.
        Characterization of the arrhythmogenic substrate in ischemic and nonischemic cardiomyopathy implications for catheter ablation of hemodynamically unstable ventricular tachycardia.
        J Am Coll Cardiol. 2010; 55: 2355-2365
        • Marchlinski F.E.
        • Callans D.J.
        • Gottlieb C.D.
        • et al.
        Linear ablation lesions for control of unmappable ventricular tachycardia in patients with ischemic and nonischemic cardiomyopathy.
        Circulation. 2000; 101: 1288-1296
        • Hsia H.H.
        • Lin D.
        • Sauer W.H.
        • et al.
        Anatomic characterization of endocardial substrate for hemodynamically stable reentrant ventricular tachycardia: identification of endocardial conducting channels.
        Heart Rhythm. 2006; 3: 503-512
        • Josephson M.E.
        • Waxman H.L.
        • Cain M.E.
        • et al.
        Ventricular activation during ventricular endocardial pacing. II. Role of pace-mapping to localize origin of ventricular tachycardia.
        Am J Cardiol. 1982; 50: 11-22
        • de Bakker J.M.
        • van Capelle F.J.
        • Janse M.J.
        • et al.
        Reentry as a cause of ventricular tachycardia in patients with chronic ischemic heart disease: electrophysiologic and anatomic correlation.
        Circulation. 1988; 77: 589-606
        • Mountantonakis S.E.
        • Park R.E.
        • Frankel D.S.
        • et al.
        Relationship between voltage map “channels” and the location of critical isthmus sites in patients with post-infarction cardiomyopathy and ventricular tachycardia.
        J Am Coll Cardiol. 2013; 61: 2088-2095
        • Arenal A.
        • del Castillo S.
        • Gonzalez-Torrecilla E.
        • et al.
        Tachycardia-related channel in the scar tissue in patients with sustained monomorphic ventricular tachycardias: influence of the voltage scar definition.
        Circulation. 2004; 110: 2568-2574
        • Perez-David E.
        • Arenal A.
        • Rubio-Guivernau J.L.
        • et al.
        Noninvasive identification of ventricular tachycardia-related conducting channels using contrast-enhanced magnetic resonance imaging in patients with chronic myocardial infarction: comparison of signal intensity scar mapping and endocardial voltage mapping.
        J Am Coll Cardiol. 2011; 57: 184-194
        • Soejima K.
        • Stevenson W.G.
        • Maisel W.H.
        • et al.
        Electrically unexcitable scar mapping based on pacing threshold for identification of the reentry circuit isthmus: feasibility for guiding ventricular tachycardia ablation.
        Circulation. 2002; 106: 1678-1683
        • Jais P.
        • Maury P.
        • Khairy P.
        • et al.
        Elimination of local abnormal ventricular activities: a new end point for substrate modification in patients with scar-related ventricular tachycardia.
        Circulation. 2012; 125: 2184-2196
        • Arenal A.
        • Glez-Torrecilla E.
        • Ortiz M.
        • et al.
        Ablation of electrograms with an isolated, delayed component as treatment of unmappable monomorphic ventricular tachycardias in patients with structural heart disease.
        J Am Coll Cardiol. 2003; 41: 81-92
        • Hsia H.H.
        • Lin D.
        • Sauer W.H.
        • et al.
        Relationship of late potentials to the ventricular tachycardia circuit defined by entrainment.
        J Interv Card Electrophysiol. 2009; 26: 21-29
        • Bogun F.
        • Good E.
        • Reich S.
        • et al.
        Isolated potentials during sinus rhythm and pace-mapping within scars as guides for ablation of post-infarction ventricular tachycardia.
        J Am Coll Cardiol. 2006; 47: 2013-2019
        • Komatsu Y.
        • Daly M.
        • Sacher F.
        • et al.
        Electrophysiologic characterization of local abnormal ventricular activities in postinfarction ventricular tachycardia with respect to their anatomic location.
        Heart Rhythm. 2013; 10: 1630-1637
        • Brunckhorst C.B.
        • Delacretaz E.
        • Soejima K.
        • et al.
        Ventricular mapping during atrial and right ventricular pacing: relation of electrogram parameters to ventricular tachycardia reentry circuits after myocardial infarction.
        J Interv Card Electrophysiol. 2004; 11: 183-191
        • Priori S.G.
        • Blomstrom-Lundqvist C.
        • Mazzanti A.
        • et al.
        2015 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: the task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC).
        Eur Heart J. 2015; 36: 2793-2867
        • Santangeli P.
        • Marchlinski F.E.
        Substrate mapping for unstable ventricular tachycardia.
        Heart Rhythm. 2016; 13: 569-583
        • Cooper M.J.
        • Hunt L.J.
        • Palmer K.J.
        • et al.
        Quantitation of day to day variability in mode of induction of ventricular tachyarrhythmias by programmed stimulation.
        J Am Coll Cardiol. 1988; 11: 101-108
        • McPherson C.A.
        • Rosenfeld L.E.
        • Batsford W.P.
        Day-to-day reproducibility of responses to right ventricular programmed electrical stimulation: implications for serial drug testing.
        Am J Cardiol. 1985; 55: 689-695
        • Sacher F.
        • Lim H.S.
        • Derval N.
        • et al.
        Substrate mapping and ablation for ventricular tachycardia: the LAVA approach.
        J Cardiovasc Electrophysiol. 2015; 26: 464-471
        • Silberbauer J.
        • Oloriz T.
        • Maccabelli G.
        • et al.
        Noninducibility and late potential abolition: a novel combined prognostic procedural end point for catheter ablation of postinfarction ventricular tachycardia.
        Circ Arrhythm Electrophysiol. 2014; 7: 424-435
        • Tung R.
        • Mathuria N.S.
        • Nagel R.
        • et al.
        Impact of local ablation on interconnected channels within ventricular scar: mechanistic implications for substrate modification.
        Circ Arrhythm Electrophysiol. 2013; 6: 1131-1138
        • Berruezo A.
        • Fernandez-Armenta J.
        • Andreu D.
        • et al.
        Scar dechanneling: new method for scar-related left ventricular tachycardia substrate ablation.
        Circ Arrhythm Electrophysiol. 2015; 8: 326-336
        • Tzou W.S.
        • Frankel D.S.
        • Hegeman T.
        • et al.
        Core isolation of critical arrhythmia elements for treatment of multiple scar-based ventricular tachycardias.
        Circ Arrhythm Electrophysiol. 2015; 8: 353-361
        • Reddy V.Y.
        • Reynolds M.R.
        • Neuzil P.
        • et al.
        Prophylactic catheter ablation for the prevention of defibrillator therapy.
        N Engl J Med. 2007; 357: 2657-2665
        • Stevenson W.G.
        • Wilber D.J.
        • Natale A.
        • et al.
        Irrigated radiofrequency catheter ablation guided by electroanatomic mapping for recurrent ventricular tachycardia after myocardial infarction: the multicenter thermocool ventricular tachycardia ablation trial.
        Circulation. 2008; 118: 2773-2782
        • Kuck K.H.
        • Schaumann A.
        • Eckardt L.
        • et al.
        Catheter ablation of stable ventricular tachycardia before defibrillator implantation in patients with coronary heart disease (VTACH): a multicentre randomised controlled trial.
        Lancet. 2010; 375: 31-40
        • Tanner H.
        • Hindricks G.
        • Volkmer M.
        • et al.
        Catheter ablation of recurrent scar-related ventricular tachycardia using electroanatomical mapping and irrigated ablation technology: results of the prospective multicenter Euro-VT-study.
        J Cardiovasc Electrophysiol. 2010; 21: 47-53
        • Dinov B.
        • Fiedler L.
        • Schonbauer R.
        • et al.
        Outcomes in catheter ablation of ventricular tachycardia in dilated nonischemic cardiomyopathy compared with ischemic cardiomyopathy: results from the Prospective Heart Centre of Leipzig VT (HELP-VT) Study.
        Circulation. 2014; 129: 728-736
        • Tung R.
        • Josephson M.E.
        • Reddy V.
        • et al.
        Influence of clinical and procedural predictors on ventricular tachycardia ablation outcomes: an analysis from the substrate mapping and ablation in Sinus Rhythm to Halt Ventricular Tachycardia Trial (SMASH-VT).
        J Cardiovasc Electrophysiol. 2010; 21: 799-803
        • Sosa E.
        • Scanavacca M.
        • D'Avila A.
        • et al.
        Endocardial and epicardial ablation guided by nonsurgical transthoracic epicardial mapping to treat recurrent ventricular tachycardia.
        J Cardiovasc Electrophysiol. 1998; 9: 229-239
        • Sosa E.
        • Scanavacca M.
        • d'Avila A.
        • et al.
        Nonsurgical transthoracic epicardial catheter ablation to treat recurrent ventricular tachycardia occurring late after myocardial infarction.
        J Am Coll Cardiol. 2000; 35: 1442-1449
        • Martinek M.
        • Stevenson W.G.
        • Inada K.
        • et al.
        QRS characteristics fail to reliably identify ventricular tachycardias that require epicardial ablation in ischemic heart disease.
        J Cardiovasc Electrophysiol. 2012; 23: 188-193
        • Tung R.
        • Michowitz Y.
        • Yu R.
        • et al.
        Epicardial ablation of ventricular tachycardia: an institutional experience of safety and efficacy.
        Heart Rhythm. 2013; 10: 490-498
        • Di Biase L.
        • Santangeli P.
        • Burkhardt D.J.
        • et al.
        Endo-epicardial homogenization of the scar versus limited substrate ablation for the treatment of electrical storms in patients with ischemic cardiomyopathy.
        J Am Coll Cardiol. 2012; 60: 132-141
        • Sacher F.
        • Wright M.
        • Derval N.
        • et al.
        Endocardial versus epicardial ventricular radiofrequency ablation: utility of in vivo contact force assessment.
        Circ Arrhythm Electrophysiol. 2013; 6: 144-150
        • Mizuno H.
        • Vergara P.
        • Maccabelli G.
        • et al.
        Contact force monitoring for cardiac mapping in patients with ventricular tachycardia.
        J Cardiovasc Electrophysiol. 2013; 24: 519-524
        • Thiagalingam A.
        • D'Avila A.
        • Foley L.
        • et al.
        Importance of catheter contact force during irrigated radiofrequency ablation: evaluation in a porcine ex vivo model using a force-sensing catheter.
        J Cardiovasc Electrophysiol. 2010; 21: 806-811
        • Koruth J.S.
        • Dukkipati S.
        • Miller M.A.
        • et al.
        Bipolar irrigated radiofrequency ablation: a therapeutic option for refractory intramural atrial and ventricular tachycardia circuits.
        Heart Rhythm. 2012; 9: 1932-1941
        • Sapp J.L.
        • Cooper J.M.
        • Soejima K.
        • et al.
        Deep myocardial ablation lesions can be created with a retractable needle-tipped catheter.
        Pacing Clin Electrophysiol. 2004; 27: 594-599
        • Callans D.J.
        • Ren J.F.
        • Narula N.
        • et al.
        Left ventricular catheter ablation using direct, intramural ethanol injection in swine.
        J Interv Card Electrophysiol. 2002; 6: 225-231
        • Sapp J.L.
        • Beeckler C.
        • Pike R.
        • et al.
        Initial human feasibility of infusion needle catheter ablation for refractory ventricular tachycardia.
        Circulation. 2013; 128: 2289-2295
        • Vaseghi M.
        • Shivkumar K.
        The role of the autonomic nervous system in sudden cardiac death.
        Prog Cardiovasc Dis. 2008; 50: 404-419
        • Shen M.J.
        • Zipes D.P.
        Role of the autonomic nervous system in modulating cardiac arrhythmias.
        Circ Res. 2014; 114: 1004-1021
        • Bourke T.
        • Vaseghi M.
        • Michowitz Y.
        • et al.
        Neuraxial modulation for refractory ventricular arrhythmias: value of thoracic epidural anesthesia and surgical left cardiac sympathetic denervation.
        Circulation. 2010; 121: 2255-2262
        • Vaseghi M.
        • Gima J.
        • Kanaan C.
        • et al.
        Cardiac sympathetic denervation in patients with refractory ventricular arrhythmias or electrical storm: intermediate and long-term follow-up.
        Heart Rhythm. 2014; 11: 360-366
        • Ukena C.
        • Bauer A.
        • Mahfoud F.
        • et al.
        Renal sympathetic denervation for treatment of electrical storm: first-in-man experience.
        Clin Res Cardiol. 2012; 101: 63-67
        • Sapp J.L.
        • Wells G.A.
        • Parkash R.
        • et al.
        Ventricular tachycardia ablation versus escalation of antiarrhythmic drugs.
        N Engl J Med. 2016; 375: 111-121
        • Tung R.
        • Vaseghi M.
        • Frankel D.S.
        • et al.
        Freedom from recurrent ventricular tachycardia after catheter ablation is associated with improved survival in patients with structural heart disease: an International VT Ablation Center Collaborative Group study.
        Heart Rhythm. 2015; 12: 1997-2007
        • Pedersen C.T.
        • Kay G.N.
        • Kalman J.
        • et al.
        EHRA/HRS/APHRS expert consensus on ventricular arrhythmias.
        Heart Rhythm. 2014; 11: e166-e196
        • Jamil-Copley S.
        • Vergara P.
        • Carbucicchio C.
        • et al.
        Application of ripple mapping to visualize slow conduction channels within the infarct-related left ventricular scar.
        Circ Arrhythm Electrophysiol. 2015; 8: 76-86