Catheter Ablation of Idiopathic Ventricular Arrhythmias

Heart Lung Circ. 2019 Jan;28(1):102-109. doi: 10.1016/j.hlc.2018.10.012. Epub 2018 Oct 17.

Abstract

Ventricular arrhythmias (VA) are observed in the setting of structural heart disease. However, in a proportion of patients presenting with VT, the routine diagnostic modalities fail to demonstrate overt myocardial abnormality. These arrhythmias have been called idiopathic VAs. They consist of various subtypes that have been defined by their anatomic location of origin within the heart and/or their underlying mechanism. While the majority of patients are asymptomatic, some experience debilitating symptoms and may develop reversible ventricular dysfunction. Catheter ablation has been traditionally reserved for patients with incapacitating symptoms or progressive ventricular dysfunction. However, as many patients are young, and catheter ablation can be curative in >90% of cases with a low risk (<1%) of serious complications, it is increasingly being offered as a first-line treatment in symptomatic patients. The approach to arrhythmia mapping is guided by the 12-lead electrocardiograph (ECG) morphology of the ventricular tachycardia (VT). Use of three dimensional (3D) electroanatomic mapping systems and intra-cardiac echocardiography are helpful in localising sites for successful ablation.

Keywords: Catheter ablation; Idiopathic; Outflow tract; Ventricular tachycardia.

Publication types

  • Review

MeSH terms

  • Catheter Ablation / methods*
  • Electrocardiography*
  • Heart Conduction System / physiopathology
  • Heart Conduction System / surgery*
  • Humans
  • Tachycardia, Ventricular / physiopathology
  • Tachycardia, Ventricular / surgery*
  • Treatment Outcome