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
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Article info
Publication history
Published online: October 16, 2018
Identification
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© 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
