March 11, 2012Open Access
View Full PaperCatheter ablation of ventricular tachycardia in ischaemic and non-ischaemic cardiomyopathy: where are we today? A clinical review
Key Result
Catheter ablation for ventricular tachycardia in patients with ischaemic heart disease prevents recurrence of VT and decreases the number of ICD shocks.
Structured PICO
Does catheter ablation prevent recurrence of ventricular tachycardia and decrease ICD shocks in patients with ischaemic and non-ischaemic cardiomyopathy?
P
Population
Patients with ischaemic cardiomyopathy (ICM) or non-ischaemic cardiomyopathy (NICM) at risk for sudden cardiac death
I
Intervention
Catheter ablation for ventricular tachycardia (VT)
Catheter ablation is an effective strategy to prevent VT recurrence and reduce ICD shocks in patients with ischaemic cardiomyopathy.
Abstract
According to the current guidelines, patients with ischaemic cardiomyopathy (ICM) or non-ischaemic cardiomyopathy (NICM) at risk for sudden cardiac death should undergo implantation of an implantable cardioverter-defibrillator (ICD). Although ICDs effectively terminate ventricular arrhythmias, the arrhythmogenic substrate remains unchanged or may progress over time, resulting in recurrent ICD shocks. Defibrillator shocks increase mortality and worsen quality of life. Evidence from two prospective randomized trials on outcome in patients with ischaemic heart disease undergoing catheter ablation for ventricular tachycardia (VT) suggests that ablation prevents recurrence of VT and decreases the number of ICD shocks. This review will highlight the recent progress made in the ablative treatment of VT in patients with ICM and NICM.