Substrate-based approaches in ventricular tachycardia ablation
Citations Over TimeTop 11% of 2022 papers
Abstract
Catheter ablation for ventricular tachycardia (VT) in patients with structural heart disease is now part of standard care. Mapping and ablation of the clinical VT is often limited when the VT is noninducible, nonsustained or not haemodynamically tolerated. Substrate-based ablation strategies have been developed in an aim to treat VT in this setting and, subsequently, have been shown to improve outcomes in VT ablation when compared to focused ablation of mapped VTs. Since the initial description of linear ablation lines targeting ventricular scar, many different approaches to substrate-based VT ablation have been developed. Strategies can broadly be divided into three categories: 1) targeting abnormal electrograms, 2) anatomical targeting of conduction channels between areas of myocardial scar, and 3) targeting areas of slow and/or decremental conduction, identified with "functional" substrate mapping techniques. This review summarises contemporary substrate-based ablation strategies, along with their strengths and weaknesses.
Related Papers
- → Imaging-guided Ventricular Tachycardia Ablation(2013)27 cited
- → Amiodarone reduces the amount of ablation during catheter ablation for persistent atrial fibrillation(2014)16 cited
- → Pulsed Field Ablation: a Novel Therapeutic Tool for Catheter-Based Treatment of Atrial Fibrillation(2022)8 cited
- → Perpendicular catheter orientation during papillary muscle ablation results in larger, deeper lesions(2022)8 cited
- → Anatomically Guided Catheter Ablation for Atrial Fibrillation(2008)2 cited