Role of Imaging Techniques in Catheter Ablation of Ventricular Tachycardia

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by progressive fibro-fatty replacement of the myocardium that represents the substrate for recurrent sustained ventricular tachycardia (VT). These arrhythmias characterize the clinical course of a sizeable proportion of patients and have significant implications for their quality of life and long-term prognosis. Antiarrhythmic drugs are often poorly tolerated and usually provide incomplete control of arrhythmia relapses. Catheter ablation is a potentially effective strategy to treat frequent VT episodes and ICD shocks in ARVC patients. The aims of this review are to discuss the electrophysiological and electroanatomic substrates of ventricular tachycardia in patients with ARVC and to analyze the role of catheter ablation in their management with particular reference to selection of patients, technical issues, potential complications and outcomes.

Download Full-text

Catheter ablation of idiopathic fascicular ventricular tachycardia: The role of isolated diastolic potentials during mapping in sinus rhythm

International Journal of Cardiology ◽

10.1016/j.ijcard.2015.08.008 ◽

2015 ◽

Vol 201 ◽

pp. 212-214 ◽

Cited By ~ 1

Author(s):

Konstantinos P. Letsas ◽

Michael Efremidis ◽

Konstantinos Vlachos ◽

Dimitrios Asvestas ◽

Stamatis Georgopoulos ◽

...

Keyword(s):

Ventricular Tachycardia ◽

Catheter Ablation ◽

Sinus Rhythm

Download Full-text

Role of Electrophysiological Study and Catheter Ablation for Recurrent Ventricular Tachycardia Complicating Myocarditis

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2015.63 ◽

2012 ◽

Vol 55 (2) ◽

pp. 96-99

Author(s):

Emanuele Cecchi ◽

Serena Fatucchi ◽

Elena Crudeli ◽

Cristina Giglioli

Keyword(s):

Ventricular Tachycardia ◽

Cardiac Magnetic Resonance ◽

Catheter Ablation ◽

Ventricular Arrhythmias ◽

Acute Myocarditis ◽

Electrophysiological Study ◽

Interventricular Septum ◽

Arrhythmogenic Substrate ◽

Rule Out

Here we report the case of a 31-year-old man admitted to our hospital with echocardiografic and Cardiac Magnetic Resonance signs of myocarditis complicated by ventricular tachycardia, initially resolved with direct current shock. After the recurrence of ventricular tachycardia the patient was submitted to electrophysiological study revealing a re-entrant circuit at the level of the medium segment of interventricular septum, successfully treated with transcatheter ablation. This case highlights how the presence of recurrent ventricular arrhythmias at the onset of acute myocarditis, suspected or proven, could be associated with a pre-existing arrhythmogenic substrate, therefore these patients should be submitted to electrophysiological study in order to rule out the presence of arrhythmogenic focuses that can be treated with transcatheter ablation.

Download Full-text

Prophylactic Catheter Ablation for Ventricular Tachycardia: Are We There Yet?

Arrhythmia & Electrophysiology Review ◽

10.15420/aer.2017:17:1 ◽

2017 ◽

Vol 6 (3) ◽

pp. 125 ◽

Cited By ~ 2

Author(s):

Rahul K Mukherjee ◽

Louisa O’Neill ◽

Mark D O’Neill ◽

◽

...

Keyword(s):

Ventricular Tachycardia ◽

Catheter Ablation ◽

Disease Process ◽

Sufficient Evidence ◽

Optimal Timing ◽

Success Rates ◽

Randomised Controlled ◽

Contemporary Practice

Ventricular tachycardia (VT), often degenerating into ventricular fibrillation, is the leading cause of sudden cardiac death. Catheter ablation of VT is associated with relatively low, long-term success rates, while the optimal timing of ablation in patients with ischaemic and nonischaemic cardiomyopathy remains unclear. Contemporary practice in most centres is to consider ablation late in the disease process following the failure of anti-arrhythmic medications and/or following recurrent implantable cardioverter-defibrillator shocks. Three major randomised, controlled trials have been published investigating the role of prophylactic catheter ablation for VT. In the present review, we assess the evidence from these and other related trials in VT ablation to understand if there is sufficient evidence to advocate prophylactic catheter ablation in patients with VT.

Download Full-text