Updates in Ventricular Tachycardia Ablation

Timothy Campbell; Richard G Bennett; Yasuhito Kotake; Saurabh Kumar

doi:10.4070/kcj.2020.0436

Updates in Ventricular Tachycardia Ablation

Korean Circ J. 2021 Jan;51(1):15-42. doi: 10.4070/kcj.2020.0436.

Authors

Timothy Campbell^{1

2}, Richard G Bennett^{1

2}, Yasuhito Kotake^{1

2}, Saurabh Kumar^{1

3}

Affiliations

¹ Department of Cardiology, Westmead Hospital, Sydney, Australia.
² Westmead Applied Research Centre, University of Sydney, New South Wales, Australia.
³ Westmead Applied Research Centre, University of Sydney, New South Wales, Australia. saurabh.kumar@sydney.edu.au.

Abstract

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.

Keywords: Multimodal imaging; Radiofrequency ablation; Sympathectomy; Ventricular arrhythmias; Ventricular tachycardia.

Publication types

Review