Catheter Ablation of Ventricular Tachycardia in Structural Heart Disease: Indications, Strategies, and Outcomes-Part II.

Abstract

In contrast to ventricular tachycardia (VT) that occurs in the setting of a structurally normal heart, VT that occurs in patients with structural heart disease carries an elevated risk for sudden cardiac death (SCD), and implantable cardioverter-defibrillators (ICDs) are the mainstay of therapy. In these individuals, catheter ablation may be used as adjunctive therapy to treat or prevent repetitive ICD therapies when antiarrhythmic drugs are ineffective or not desired. However, certain patients with frequent premature ventricular contractions (PVCs) or VT and tachycardiomyopathy should be considered for ablation before ICD implantation because left ventricular function may improve, consequently decreasing the risk of SCD and obviating the need for an ICD. The goal of this paper is to review the pathophysiology, mechanism, and management of VT in the setting of structural heart disease and discuss the evolving role of catheter ablation in decreasing ventricular arrhythmia recurrence.

• Authors: Srinivas R Dukkipati, Jacob S Koruth, Subbarao Choudry, Marc A Miller, William Whang, Vivek Y Reddy
• Journal: Journal of the American College of Cardiology (J Am Coll Cardiol) Vol. 70 Issue 23 Pg. 2924-2941 (Dec 12 2017) ISSN: 1558-3597 [Electronic] United States
• PMID: 29216988 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Topics

• Catheter Ablation
• Heart Diseases (complications, physiopathology, surgery)
• Humans
• Patient Selection
• Tachycardia, Ventricular (pathology, physiopathology, surgery)
• Treatment Outcome