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00925njm 22002777a 4500 dc Bhaskaran, Abhishek author Fitzgerald, John author Jackson, Nicholas author Gizurarson, Sigfus author Nanthakumar, Kumaraswamy author Porta-Sanchez, Andreu author 2020-12 Empirical approaches to targeting the ventricular tachycardia (VT) substrate include mapping of late potentials, local abnormal electrogram, pace-mapping and homogenisation of the abnormal signals. These approaches do not try to differentiate between the passive or active role of local signals as the critical components of the VT circuit. By not considering the functional components, these approaches often view the substrate as a fixed anatomical barrier. Strategies to improve the success of VT ablation need to include the identification of critical functional substrate. Decrement-evoked potential (DeEP) mapping has been developed to elucidate this using an extra-stimulus added to a pacing drive train. With knowledge translation in mind, the authors detail the evolution of the DeEP concept by way of a study of simultaneous panoramic endocardial mapping in VT ablation; an in silico modelling study to demonstrate the factors influencing DeEPs; a multicentre VT ablation validation study; a practical approach to DeEP mapping; the potential utility of DeEPs to identify arrhythmogenic atrial substrate; and, finally, other functional mapping strategies. Arrhythm Electrophysiol Rev. 2020; 9(4):211-218 2050-3369 http://hdl.handle.net/20.500.12105/12868 33437489 10.15420/aer.2020.25 Arrhythmia & electrophysiology review Decrement Evoked Potential Mapping to Guide Ventricular Tachycardia Ablation: Elucidating the Functional Substrate.