Epicardial Mapping and Ablation after Stereotactic Arrhythmia Radioablation for Ventricular Tachycardia Using a Novel Mapping Catheter

Published July 10, 2025 | Version v1

Journal article Open

1. Department of Rhythmology, University Heart Center, University Hospital Schleswig Holstein, Lübeck, Germany
2. Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel, Germany
3. Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Lübeck, Germany

Key Teaching Points

Stereotactic arrhythmia radioablation (STAR) has recently emerged as a promising noninvasive treatment strategy for patients with refractory ventricular tachycardia (VT). However, its long-term electrophysiological effect on arrhythmogenic substrates is uncertain.
OPTRELL^TM, a novel multipolar mapping catheter with small electrodes arranged in a fixed array formation, provides high-density maps not only in left ventricular (LV) endocardium but also in LV epicardium. In this case, epicardial mapping using OPTRELL^TM catheter was performed three years after STAR and revealed late potentials (LPs) in the previously irradiated basal-lateral region of the LV.
The reappearance of LPs in the irradiated area suggests the re-emergence of a functional substrate for VT. Potential mechanisms for LP reappearance after STAR include incomplete or heterogeneous fibrosis, radiation-induced reprogramming of conduction pathways, or progression of underlying cardiomyopathy.

Name	Size	Download all
Epicardial Mapping and Ablation after Stereotactic Arrhythmia Radioablation for Ventricular Tachycardia Using a Novel Mapping Catheter.pdf md5:7ae7350b9da2a3cc20d6a660d08ac5f5	5.2 MB	Preview Download

European Commission
STOPSTORM - A PROSPECTIVE EUROPEAN VALIDATION COHORT FOR STEREOTACTIC THERAPY OF RE-ENTRANT TACHYCARDIA 945119