This noncontact mapping system identified diastolic portions of the circuit in most VTs studied and can safely map and guide ablation of human VT.

Although the site of latest onset of endocardial activation during SR proved to be the most sensitive indicator, the characteristics of SR electrograms did not usefully predict successful ablation sites.

There are a number of limitations associated with conventional mapping for ablation of ventricular tachycardia (VT) in ischemic heart disease, such as the high recurrence rates after initially successful ablation. The development of a noncontact mapping system capable of producing high-resolution isopotential maps of the entire left ventricle has enabled rapid identification of diastolic activity that maintains VT for ablation. With this system it is possible to map nonsustained and fast unstable as well as stable VTs. In this article we review the historic background and concepts of noncontact mapping, its clinical application, and the results of ablations for human VT guided by this mapping system.

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