TY - JOUR
T1 - VT ablation
T2 - New developments and approaches
AU - Ling, Zhiyu
AU - Hari, Adithya
AU - Tandri, Harikrishna
N1 - Funding Information:
Dr. Zhiyu Ling and Dr. Adithya Hari each declare no potential conflict of interest relevant to this article. Dr. Harikrishna Tandri received a grant from NIH.
PY - 2014/4
Y1 - 2014/4
N2 - 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.
AB - 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.
KW - Arrhythmia
KW - Catheter ablation
KW - Heart failure
KW - ICD failure
KW - Intracardiac echocardiography
KW - Ventricular tachycardia
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U2 - 10.1007/s11936-014-0297-2
DO - 10.1007/s11936-014-0297-2
M3 - Review article
C2 - 24515355
AN - SCOPUS:84893165214
SN - 1092-8464
VL - 16
JO - Current Treatment Options in Cardiovascular Medicine
JF - Current Treatment Options in Cardiovascular Medicine
IS - 4
M1 - 297
ER -