Computed Tomography–Derived Abrupt Wall-Thickness Transitions as Complementary Markers of Ventricular Tachycardia Substrate in Ischemic Cardiomyopathy

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.