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2014 ; 16
(4
): 297
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VT ablation: New Developments and Approaches
#MMPMID24515355
Ling Z
; Hari A
; Tandri H
Curr Treat Options Cardiovasc Med
2014[Apr]; 16
(4
): 297
PMID24515355
show ga
Over the past decade, catheter ablation has emerged as an important therapeutic
option for ventricular tachycardia (VT) in both patients with and without
structural heart disease. In patients without structural heart disease, catheter
ablation serves as sole therapy for the treatment of VT. For those with
structural heart disease, VT ablation has generally been reserved for patients
who experience ICD therapies, and particularly those who fail antiarrhythmic
agents. With the growing number of patients with implantable devices as well as
improvements in heart failure therapy resulting in improved survival among ICD
patients, the overall number of patients needing therapy for VT continues to
increase. The past years have witnessed significant advances in our understanding
of the arrhythmic substrate in various cardiomyopathies, resulting in
substrate-based approaches for targeted VT ablation. Further, the growth in
better technologies and techniques for VT ablation, such as the use of
percutaneous epicardial ablation, the innovation of multielectrode catheters for
rapid mapping, the use of intracardiac echocardiography (ICE) for mapping unusual
sites, and activation and entrainment mapping of previously unmappable VTs
assisted by mechanical circulatory support devices, has overcome the limitations
and greatly improved the success rates of catheter ablation. This review
summarizes recent advances and novel approaches in both technology and techniques
for catheter ablation of ventricular tachycardia.
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