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Catheter ablation of ventricular arrhythmias: targets, tactics, and tools

Winterfield, Jeffrey R.a; Mahapatra, Srijoyb; Wilber, David J.a

Current Opinion in Cardiology: May 2013 - Volume 28 - Issue 3 - p 344–353
doi: 10.1097/HCO.0b013e328360443f
CARDIAC FAILURE: Edited by David Feldman and Josef Stehlik

Purpose of review Drug-refractory ventricular tachycardia in the setting of structural heart disease results in frequent implantable cardioverter defibrillator therapies and an increased risk of heart failure. Management requires catheter ablation procedures for effective suppression of the arrhythmia.

Recent findings Imaging and electroanatomic mapping technologies provide new insights into the myocardial structural abnormalities responsible for ventricular tachycardia. Integration of imaging data with three-dimensional mapping systems coupled with improved targeting of abnormal electrical signals may improve the ablation outcomes. New ablation tools show promise for the effective ablation of previously unreachable myocardial ventricular tachycardia circuits.

Summary Catheter ablation procedures have evolved over the last 2 decades. Improved technology may contribute to more widespread utilization of catheter ablation in the future.

aCardiovascular Institute, Loyola University Medical Center, Maywood, Illinois

bCardiovascular and Ablation Therapy Division, St Jude Medical, St Paul, Minnesota, USA

Correspondence to Jeffrey R. Winterfield, MD, Cardiovascular Institute, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA. Tel: +1 708 216 2653; fax: +1 708 216 6829; e-mail: jwinterfield@lumc.edu

© 2013 Lippincott Williams & Wilkins, Inc.