Cardiac magnetic resonance–guided pacemapping for ventricular tachycardia substrate ablation in sinus rhythm in a patient with nonischemic cardiomyopathy

Substrate mapping–guided ablation is a recommended therapeutic option in patients with recurrent episodes of scar-related ventricular tachycardia (VT).1 Color-coded pixel signal intensity (PSI) maps obtained from preprocedural late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) imaging can be used for identification and characterization of arrhythmic substrate.2 PSI maps permit visualizing the border zone areas distribution inside the scar as corridors of viable tissue connecting the healthy myocardium, defined as heterogeneous tissue channels (HTCs), that correlate with the conducting channels on the electroanatomical mapping (EAM).