Ischemic VT ablation focuses on which location?

• A. Scar-Related Isthmus
• B. RVOT
• C. LV Summit
• D. Atrioventricular Node

Answer: (A)

Ischemic VT ablation centers on the scar-related isthmus—the narrow conducting channel within or between post-infarct scar tissue that forms the critical part of a reentrant VT circuit. After a myocardial infarction, scar replaces normal myocardium and surviving conducting strands in the border zones create a loop that can sustain VT. The isthmus is the slow, crucial path through which the impulse must pass to complete the circuit. Ablation aims to disrupt this pathway by creating lesions across the isthmus or its borders, effectively blocking conduction and terminating the reentrant tachycardia. This is usually done from the endocardial surface of the left ventricle, though epicardial ablation may be required if the scar involves the epicardium. Other VT sites like the RV outflow tract or LV summit are associated with different VT etiologies, and the AV node is not a substrate for ischemic VT ablation.