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Catheter ablation of ventricular tachycardia


Authors: J. Kautzner
Authors‘ workplace: Klinika kardiologie IKEM, Praha
Published in: Kardiol Rev Int Med 2006, 8(Supplementum): 37-42

Overview

Ventricular tachycardias comprise a wide spectrum of arrhythmias originating in ventricular myocardium and/or in ventricular conduction system tissue. Prognostically, it is useful to differentiate benign idiopathic forms and arrhythmias associated with structural heart disease that may be life-threatening. The most frequent arrhythmia in the former group is focal ventricular tachycardia from the right (or less frequently left) ventricular outflow tract and/or reentrant tachycardia originating in the conduction system of the left ventricle. In both cases, catheter ablation has become the method of choice and allows successful elimination of arrhythmia in high percentage of cases (more than 90%). Implantable cardioverters-defibrillators are more and more frequently used in management of ventricular tachycardias associated with structural heart disease. However, catheter ablation can be used in the case of more frequent arrhythmia episodes in order to modify arrhythmogenic substrate and prevent arrhythmia recurrences. Catheter ablation is preferred in incessant ventricular tachycardias and/or in management of arrhythmia storms. Modern electrophysiologic mapping systems enable exact characterization of the arrhythmogenic substrate and precise identification of target for radiofrequency ablation.

Keywords:
catheter ablation – ventricular tachycardia – ischemic heart disease – cardiomyopathy


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