ARRHYTHMIAS: Edited by David H. BirnieAblation of ischemic ventricular tachycardia evidence, techniques, results, and future directionsBaldinger, Samuel H.; Stevenson, William G.; John, Roy M.Author Information Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA Correspondence to Roy M. John, MD, PhD, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street Boston, MA 02115, USA. E-mail: [email protected] Current Opinion in Cardiology: January 2016 - Volume 31 - Issue 1 - p 29-36 doi: 10.1097/HCO.0000000000000237 Buy Metrics Abstract Purpose of review This article summarizes current understanding of the arrhythmia substrate and effect of catheter ablation for infarct-related ventricular tachycardia, focusing on recent findings. Recent findings Clinical studies support the use of catheter ablation earlier in the course of ischemic disease with moderate success in reducing arrhythmia recurrence and shocks from implantable defibrillators, although mortality remains unchanged. Ablation can be lifesaving for patients presenting with electrical storm. Advanced mapping systems with image integration facilitate identification of potential substrate, and several different approaches to manage hemodynamically unstable ventricular tachycardia have emerged. Novel ablation techniques that allow deeper lesion formation are in development. Summary Catheter ablation is an important therapeutic option for preventing or reducing episodes of ventricular tachycardia in patients with ischemic cardiomyopathy. Present technologies allow successful ablation in the majority of patients, even when the arrhythmia is hemodynamically unstable. Failure of the procedure is often because of anatomic challenges that will hopefully be addressed with technological progress. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.