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fractionated electrograms). Maps are shown in three views. Asterisk in the AI map marks the
(normal) RV breakthrough site of earliest epicardial activation. Arrows show direction of wave
front propagation. Latest activation is in LV apex (dark blue) which is abnormal. ESM depicts an
electrical scar in the apex, where activation terminates abnormally. 2. Anatomical scar map from
MRI (gold) shows a similar scar morphology to that of the electrical scar in ESM. 3. Four selected
EGMs from non-scar region (blue) and from scar region (red) (location indicated on ESM).
Scar EGMs are shown together with non-scar EGMs to emphasize magnitude differences, and an
amplified scale to show clearly multiple deflections (fractionation). B. Inferior MI. Similar format to
A. ESM shows electrical scar that extends across the inferior wall and towards the apex, consistent
with the anatomical scar. Activation of the inferior septum is abnormal (pink region in AI map).
Note close correspondence between the electrical scar and anatomical scar even for the complex
scar morphology. From Cuculich et. al. [281] with permission of Elsevier.

Figure 5.12. Late potentials within electrical scar: examples from three patients. A. Infero-septal
scar. B. Antero-apical scar. C. Complex anterior, apical and inferior infarction. Letters next to
electrograms correspond to their location on the ESM scar map. Delayed deflections
(late potentials) are identified by a frame. Note that all late potentials are within the electrical
scar. From Cuculich et. al. [281] with permission of Elsevier.