The Substrate of Ventricular Tachycardia

  • J. Anthony GomesEmail author


Defibrillation and synchronized cardioversion are capable of summarily stopping ventricular fibrillation (VF) and ventricular tachycardia (VT). However, these interventions developed in the twentieth century did not address the “substrate,” nor could they prevent VT recurrence and sudden cardiac death (SCD). In this chapter the author reviews the history of deciphering the mechanisms of VT in the animal model and in man, including bundle-branch-reentry, and the pioneers behind these discoveries that ultimately resulted in identifying the pathophysiology of the substrate of VT in remote infarcts leading to its surgical treatment. The author also discusses the impact of revascularization (thrombolysis and primary stenting) on the post-infarct substrate, as well as the current status of surgical resection of the VT substrate.


Substrate Bundle branch reentry Diastolic activity Aneurysm Double loop Arc Functional conduction block Figure-of-8 Ventriculotomy Endocardial resection 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Icahn School of MedicineMount Sinai HospitalNew YorkUSA

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