Catheter Ablation of Ventricular Tachycardia

A B S T R A C T Catheter ablation is highly successful and may be considered as the first line treatment in all symptomatic idiopathic forms of ventricular tachycardia (VT). Also ablation plays an important role in recurrent VTs associated with structural heart disease and relatively preserved left ventricular ejection fraction (>35%) and/or bundle branch reentry VT. It also constitutes the preferable treatment modality in incessant VTs of any origin and in patients with implantable defibrillator (ICD) devices who present with recurrent VTs and/or an electrical storm leading to multiple ICD shocks Catheter ablation appears to improve arrhythmia control in about two thirds of patients with structural heart disease and mappable VTs. Novel substrate and/or noncontact mapping techniques suggest that even hemodynamically unstable VTs and/or VTs of multiple morphologies can be successfully ablated. As the ablation method is not curative and there remains the risk of dying suddenly in patients with depressed left ventricular ejection fraction, the majority of patients with VT associated with structural heart disease also receive an ICD.