title: Catheter ablation of ventricular tachycardia.
abstract: The role and success rate of catheter ablation for monomorphic ventricular tachycardia (VT) depend on the mechanism and origin of the tachycardia (i.e., myocardial versus His-Purkinje system) and whether it occurs in the presence or absence of structural heart diseases. For sustained bundle-branch reentry, a form of VT associated with structural heart disease, radiofrequency catheter ablation of the right bundle-branch can be performed readily and is highly successful in eliminating this arrhythmia. Because of modest success rates of catheter ablation of VT associated with a prior infarction (between 17% and 75%), this treatment modality is usually considered for cases refractory to drug therapy and should be viewed as adjunctive therapy. The target for ablation is a critical area of slow conduction, which is selected based on earliest endocardial activation, mid-diastolic potentials, concealed entrainment, or pace mapping. Radiofrequency catheter ablation may be the treatment of choice in patients with VT and no apparent structural heart disease; this is especially true for young patients who would otherwise require long-life antiarrhythmic therapy. Success rates between 75% and 100% have been reported, especially when the origin is in the right ventricular outflow tract.
authors.affiliation: Electrophysiology Laboratory, Sinai Samaritan Medical Center, Milwaukee Campus/University of Wisconsin Medical School 53233.
authors.forename: Z
authors.initials: Z
authors.lastname: Blanck
authors.forename: A
authors.initials: A
authors.lastname: Dhala
authors.forename: S
authors.initials: S
authors.lastname: Deshpande
authors.forename: J
authors.initials: J
authors.lastname: Sra
authors.forename: M
authors.initials: M
authors.lastname: Jazayeri
authors.forename: M
authors.initials: M
authors.lastname: Akhtar
mesh_terms: D002037:Bundle-Branch Block / Q000150:complications; D017115:Catheter Ablation; D003327:Coronary Disease / Q000150:complications; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000601:surgery*