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Professional Technical IVT

substrate mapping

An electrophysiology technique that identifies areas of abnormal cardiac tissue based on electrical characteristics during sinus rhythm.

Full Definition

Substrate mapping is an electroanatomical mapping technique that identifies arrhythmogenic tissue by analyzing local electrogram characteristics during sinus rhythm or atrial/ventricular pacing. The technique creates voltage maps that display areas of normal myocardium (high voltage), border zones (intermediate voltage), and dense scar (low voltage or electrically silent). Substrate mapping is particularly valuable for ventricular tachycardia ablation in patients with structural heart disease, where the arrhythmia substrate can be identified and modified even when VT is not inducible or hemodynamically tolerated. This approach enables comprehensive ablation of potential reentrant circuits within the scar tissue.

Usage

Usage note: Two words, not hyphenated; distinguish from activation mapping which requires arrhythmia induction.

In Context

  • "Substrate mapping revealed extensive low-voltage areas throughout the inferior left ventricle." — VT ablation procedure
  • "The substrate mapping approach allowed comprehensive ablation despite non-inducible ventricular tachycardia." — Technical methodology

Also known as

voltage mapping scar mapping

Contrasted with

activation mapping entrainment mapping

Don't confuse with

pace mapping isochronal mapping

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