Catheter ablation for ventricular tachycardia improves VT-free survival and reduces the burden of device therapies compared to standard medical therapy in patients with structural heart disease.
Does catheter ablation improve ventricular tachycardia-free survival and reduce device therapies in patients with recurrent ventricular tachycardia compared to standard medical therapy?
This state-of-the-art review highlights that catheter ablation is superior to escalated anti-arrhythmic drug therapy for reducing VT recurrence and ICD shocks, and outlines recent advances in pre-procedural imaging and mapping techniques.
Sudden cardiac death (SCD) due to recurrent ventricular tachycardia is an important clinical sequela in patients with structural heart disease. As a result, ventricular tachycardia (VT) has emerged as a major clinical and public health problem. The mechanism of VT is predominantly mediated by re-entry in the presence of arrhythmogenic substrate (scar), though focal mechanisms are also important. Catheter ablation for VT, when compared to standard medical therapy, has been shown to improve VT-free survival and burden of device therapies. Approaches to VT ablation are dependent on the underlying disease process, broadly classified into idiopathic (no structural heart disease) or structural heart disease (ischemic or non-ischemic heart disease). This update aims to review recent advances made for the treatment of VT ablation, with respect to current clinical trials, peri-procedure risk assessments, pre-procedural cardiac imaging, electro-anatomic mapping and advances in catheter and non-catheter based ablation techniques.
Campbell et al. (2020) conducted a review in Ventricular tachycardia. Catheter ablation vs. Medical therapy was evaluated. Catheter ablation for ventricular tachycardia improves VT-free survival and reduces the burden of device therapies compared to standard medical therapy in patients with structural heart disease.