Key result
Catheter ablation of ventricular tachycardia in non-ischemic cardiomyopathy requires advanced techniques to target deep intramural and epicardial substrates, improving symptoms and reducing device therapy burden.
Why the study?
Non-ischemic cardiomyopathies pose significant management challenges regarding ventricular tachycardias, where catheter ablation approaches are governed heavily by specific disease processes and differ distinctly from ischemic cardiomyopathy.
This review highlights the role, techniques, and challenges of catheter ablation for ventricular tachycardia in patients with non-ischemic cardiomyopathy, emphasizing the need to target epicardial and deep intramural substrates.
May support advanced ablation techniques in NICM VT; leaves open need for prospective RCTs before practice change.
Non-ischemic cardiomyopathies are a heterogeneous group of diseases of the myocardium that have a distinct proclivity to ventricular arrhythmias. Of these, ventricular tachycardias pose significant management challenges with the risk of sudden cardiac death and morbidity from multiple causes. Catheter ablation of ventricular tachycardias is becoming an increasingly utilised intervention that has been found to have significant benefits with improving symptoms, reducing anti-arrhythmic drug burden and debilitating device therapies, thereby improving quality of life. Nonetheless, the approach to the ablation of ventricular tachycardias in non-ischemic cardiomyopathies is governed heavily by the disease process, with several distinct differences from ischemic cardiomyopathy including a preponderance to epicardial and deep intramural substrate. This contemporary review aims to present the various disease processes within non-ischemic cardiomyopathies, catheter ablation techniques which have been developed to target ventricular tachycardia and more novel adjunctive therapeutic measures.
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Bhaskaran et al. (2019) conducted a review in Non-ischemic cardiomyopathy with ventricular tachycardia. Catheter ablation was evaluated. Catheter ablation of ventricular tachycardia in non-ischemic cardiomyopathy requires advanced techniques to target deep intramural and epicardial substrates, improving symptoms and reducing device therapy burden.
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