ReviewJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2023
The scar: the wind in the perfect storm-insights into the mysterious living tissue originating ventricular arrhythmias.
Review in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- From Ischemic Injury to Arrhythmogenic Substrate: Molecular and Histopathological Insights into Post-Infarction Sudden Cardiac Death.Life (Basel, Switzerland) · 2026Review
- Insights into the causal role of diesel exhaust particles in ventricular arrhythmogenesis: protective effects of antioxidant cerium oxide nanoparticles.Particle and fibre toxicology · 2025Article
- Adamts1 Exacerbates Post-Myocardial Infarction Scar Formation via Mechanosensing of Integrin α8.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Diagnostic value and clinical impact of cardiac magnetic resonance imaging in patients after sudden cardiac arrest: a retrospective study.Open heart · 2025Article
- High-density isochronal repolarization mapping and re-entry vulnerability estimation for scar-related ventricular tachycardia ablation: mechanistic basis, clinical application, and challenges.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Review
- Beating the heart failure odds: long-term survival after myocardial ischemia in juvenile rainbow trout.American journal of physiology. Regulatory, integrative and comparative physiology · 2024Article
- Mechanical Circulatory Support Systems in the Management of Ventricular Arrhythmias: A Contemporary Overview.Journal of clinical medicine · 2024Review
- Follow-up of intramyocardial bone marrow mononuclear cell transplantation beyond 10 years.Scientific reports · 2024Article
- Cardiac Magnetic Resonance Imaging in Heart Failure.Cardiovascular innovations and applications · 2024Article
- Solving the Reach Problem: A Review of Present and Future Approaches for Addressing Ventricular Arrhythmias Arising from Deep Substrate.Arrhythmia & electrophysiology review · 2023Review
- Elevated tissue inhibitor of metalloproteinase-1 along with left atrium hypertrophy predict atrial fibrillation recurrence after catheter ablation.Frontiers in cardiovascular medicine · 2022Article
- Cardiac magnetic resonance follow-up of COVID-19 vaccine associated acute myocarditis.Frontiers in cardiovascular medicine · 2022Article
Corrections and comments
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundArrhythmic death is very common among patients with structural heart disease, and it is estimated that in European countries, 1 per 1000 inhabitants yearly dies for sudden cardiac death (SCD), mainly as a result of ventricular arrhythmias (VA). The scar is the result of cardiac remodelling process that occurs in several cardiomyopathies, both ischemic and non-ischemic, and is considered the perfect substrate for re-entrant and non-re-entrant arrhythmias.
methodsOur aim was to review published evidence on the histological and electrophysiological properties of myocardial scar and to review the central role of cardiac magnetic resonance (CMR) in assessing ventricular arrhythmias substrate and its potential implication in risk stratification of SCD.
resultsScarring process affects both structural and electrical myocardial properties and paves the background for enhanced arrhythmogenicity. Non-uniform anisotropic conduction, gap junctions remodelling, source to sink mismatch and refractoriness dispersion are some of the underlining mechanisms contributing to arrhythmic potential of the scar. All these mechanisms lead to the initiation and maintenance of VA. CMR has a crucial role in the evaluation of patients suffering from VA, as it is considered the gold standard imaging test for scar characterization. Mounting evidences support the use of CMR not only for the definition of gross scar features, as size, localization and transmurality, but also for the identification of possible conducting channels suitable of discrete ablation. Moreover, several studies call out the CMR-based scar characterization as a stratification tool useful in selecting patients at risk of SCD and amenable to implantable cardioverter-defibrillator (ICD) implantation.
conclusionsScar represents the substrate of ventricular arrhythmias. CMR, defining scar presence and its features, may be a useful tool for guiding ablation procedures and for identifying patients at risk of SCD amenable to ICD therapy.
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