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Epicardial substrate ablation for Brugada syndrome
Brugada syndrome (BrS), characterized by the presence of coved-type ST-segment elevation followed by T-wave inversion in the right precordial electrocardiogram (ECG) leads in patients who have no structural heart disease but have a high risk of sudden cardiac death from ventricular fibrillation (VF), has captivated arrhythmia scholars and electrophysiologists for more than 2 decades. As a result, major progresses have been made toward a better understanding of the syndrome with respect to its genetic basis, underlying pathophysiology, and risk stratification.How to perform electrogram-guided atrial fibrillation ablation
Over the past decade, several mapping studies of human atrial fibrillation (AF) have made the following important observations: (1) Atrial electrograms during sustained atrial fibrillation have three distinct patterns: single potential, double potential, and complex fractionated potential(s) (CFAEs).1–3 (2) The distribution of these atrial electrograms during AF localizes to specific atrial sites, and these electrograms exhibit remarkable temporal and spatial stability.1,2 (3) The CFAE areas represent AF substrate sites and are important targets for AF ablation.
