Which endpoint is used for VT ablation?

• A. Scar homogenization and targeting the VT exit site with fewer than 10 beats of induced VT.
• B. Complete non-inducibility of any VT.
• C. Isolating the ventricles from the atria.
• D. Pacing from multiple sites until a perfect match.

Answer: (A)

The key idea is that successful VT ablation aims to modify the scar-related substrate that sustains reentry, by making the scar tissue more uniform (scar homogenization) and by eradicating the VT pathways at their critical exit sites. By doing this, the circuit is disrupted so that inducible VT is hard to sustain. A practical end point used in many labs is achieving very limited inducibility—fewer than about 10 beats of induced VT—indicating the substrate has been effectively altered and sustained VT is unlikely.

This approach directly targets the structural basis of VT rather than relying on vague or indirect markers. Isolating the ventricles from the atria isn’t relevant to VT substrate modification, and pacing from multiple sites until a “perfect match” isn’t a recognized procedural endpoint. While complete noninducibility is a common goal, the described strategy emphasizes detailed substrate modification around scar and exits to reduce inducibility to a minimal level.