In this episode, Frank Marchlinski, MD, Deputy Editor of JACC: Clinical Electrophysiology, discusses a study evaluating whether abrupt wall-thickness transitions on cardiac CT scans can help identify critical ventricular tachycardia (VT) substrate in patients with ischemic cardiomyopathy. The investigators found that these CT-derived structural markers frequently co-localized with VT isthmus boundaries and deceleration zones identified during electrophysiology studies, suggesting they may complement traditional mapping techniques and help guide VT ablation, particularly when arrhythmias are difficult to map.

Dinesh Kalra and Javed Butler discuss the development of an artificial intelligence screening tool to identify high-risk patients who should be considered for diagnostic testing for ATTR-cardiomyopathy (ATTR-CM) from an unselected heart failure (HF) population.

Francis E. Marchlinski, MD, Deputy Editor of JACC: Clinical Electrophysiology, discusses the S3-STaMP study, which evaluated a novel mapping strategy for patients with hemodynamically unstable ventricular tachycardia (VT). The investigators found that STaMP mapping, guided by the S3 functional mapping protocol, rapidly identified critical VT circuit pathways in nearly three-quarters of patients and did so without causing acute hemodynamic deterioration. These findings suggest that S3-guided STaMP mapping may offer a safe and practical approach to improve catheter ablation of otherwise difficult-to-map VT.