New strategies for ventricular tachycardia and ventricular fibrillation ablation.

Abstract

Patients with ventricular tachycardia (VT) and ventricular fibrillation (VF) and no reversible cause are difficult to treat. While implantable defibrillators prolong survival, many patients remain symptomatic due to device shocks and syncope. To address this, there have been recent advances in the catheter ablation of VT and VF. For example, non-invasive imaging has improved arrhythmia substrate characterisation, 3D catheter navigation tools have facilitated mapping of arrhythmia and substrate and ablation catheters have advanced in their ability to deliver effective lesions. However, the long-term success rates of ablation for VT and VF remain modest, with nearly half of treated patients developing recurrence within 2-3 years, and this drives the ongoing innovation in the field. This review focuses on the challenges particular to ablation of life-threatening ventricular arrhythmia, and the strategies that have been recently developed to improve procedural efficacy. Patient sub-groups that illustrate the use of new strategies are described.

• Authors: Darren A Hooks, Benjamin Berte, Seigo Yamashita, Saagar Mahida, Jean-Marc Sellal, Nora Aljefairi, Antonio Frontera, Nicolas Derval, Arnaud Denis, Mélèze Hocini, Michel Haïssaguerre, Pierre Jaïs, Frederic Sacher
• Journal: Expert review of cardiovascular therapy (Expert Rev Cardiovasc Ther) Vol. 13 Issue 3 Pg. 263-76 (Mar 2015) ISSN: 1744-8344 [Electronic] England
• PMID: 25666031 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Topics

• Animals
• Catheter Ablation (methods)
• Defibrillators, Implantable
• Humans
• Recurrence
• Survival
• Tachycardia, Ventricular (physiopathology, therapy)
• Time Factors
• Treatment Outcome
• Ventricular Fibrillation (physiopathology, therapy)