Relation of the Unipolar Low-Voltage Penumbra Surrounding the Endocardial Low-Voltage Scar to Ventricular Tachycardia Circuit Sites and Ablation Outcomes in Ischemic Cardiomyopathy

VT Recurrence as Related to Scar Ablation Sites Introduction Magnetic resonance (MR)-imaging has shown that infarct scars causing ventricular tachycardia (VT) can extend deep to and beyond bipolar low-voltage areas (LVAs) and may be a source of ablation failure. We hypothesized that the size of the unipolar LVA “penumbra” beyond the overlying bipolar scar may predict outcome of endocardial VT ablation. Methods Twenty consecutive patients with ischemic cardiomyopathy who underwent endocardial VT ablation were retrospectively reviewed. Bipolar (30–500 Hz) LVA defined as