Understanding Functional Substrate Mapping Techniques In VT Ablation To Improve Outcomes

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Mapping and ablation of post-infarct related ventricular tachycardia (VT) remains a challenge. Conventional activation and entrainment methods are limited by poorly tolerated VT’s, multiple VT’s, complex circuits and the deleterious effects of mapping in VT on cardiac, renal and cerebral function. The resultant effect is poor long term outcomes.


Classical substrate mapping techniques predominantly involve mapping ventricular scar substrate in intrinsic rhythm, however, VT circuits may be dynamic, and substrate characteristics may not be static or prevalent in intrinsic rhythm. Emerging functional substrate assessment methods of VT ablation may improve outcomes from VT ablation and may be safer by reducing the need for the patient to be in VT for prolonged periods of time.


This webinar discusses presently available techniques.

Performed By:

Andreu  Porta-Sánchez

Andreu Porta-Sánchez

Neil T Srinivasan

Neil T Srinivasan

Juan Acosta

Moderated By:

John Silberbauer

John Silberbauer


Welcome & Introduction

Dr Silberbaur

Presentation 1: DeEP Mapping with Q&A

Dr Porta-Sanchez (15 mins)

Presentation 2: Sense Protocol Mapping with Q&A

Dr Srinivasan (15 mins)

Presentation 3: Hidden Slow Conduction Identification to Improve Outcomes

Dr Acosta with Q&A (15 mins)


Dr Silberbaur

Learning Objectives

This webinar is to inform and educate on:

  • Understanding the limitations of conventional VT approaches
  • Understanding the rationale for functional substrate assessment
  • How to Practically Perform DeEP mapping
  • How to practically perform SENSE PROTOCOL mapping
  • Understand how hidden slow conduction identification improves outcomes

Target Audience

This webinar is aimed at:

  • Cardiac Electrophysiologists
  • Nurses
  • Cardiac Physiologists
  • Technicians

Faculty Biographies

Andreu  Porta-Sánchez

Andreu Porta-Sánchez

Andreu Porta-Sánchez currently leads the Arrhythmia Unit at Hospital Universitario Quirónsalud Madrid and is an assistant professor of Medicine at Universidad Europea de Madrid. He undertook a period of clinical and research training in arrhythmia at the University of Toronto, Canada, from 2014 until 2017. He has pioneered the Decrement-evoked potential (DeEP) mapping technique of functional VT ablation.

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Neil T Srinivasan

Neil T Srinivasan

Dr Neil Srinivasan is a Consultant Cardiologist and Electrophysiologist and clinical academic at The Essex Cardiothoracic Centre. He is a Senior Lecturer at ARU medical school. He was previously a Locum Consultant at the Barts Heart Centre in London where he was the lead for Ventricular Tachycardia Ablation and The Lister Hospital where he was the lead for Electrophysiology.


Dr Srinivasan trained in cardiac rhythm management at The Heart Hospital in Marylebone and the Barts Heart Centre in London. During this time he undertook a PhD at the University College London (UCL) studying the mechanisms of VT/VF. He has undertaken a period of research at Washington University St Louis USA as part of this, developing non-invasive methods (ECGi) of studying the heart rhythm. He has also undertaken an observational VT fellowship in Leiden with Professor Katja Zeppenfeld. He has presented his work at national and international conferences and co-authored many major papers in the field. Recently, has pioneered the "Sense Protocol" method of functional substrate mapping in VT which has improved outcomes in VT ablation. 

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Juan Acosta

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John Silberbauer

John Silberbauer

John Silberbauer is a Consultant Cardiologist and Electrophysiologist working at the Sussex Cardiac Centre in Brighton. He has a special interest in ventricular arrhythmia ablation and enjoys teaching and research within the field. He undertook a 2-year VT fellowship under the tutelage of Dr Paolo Della Bella in Milan and has pioneered the Coronary Vein Exit and CO2 Insufflation technique for epicardial VT access.

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