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43.19 Secondary prevention of sudden cardiac death after catheter ablation of ventricular tachycardia
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Published:July 2018
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Abstract
The number of catheter ablation procedures for ventricular tachycardia is increasing. More patients with scar-related ventricular tachycardia have preserved left ventricular function. Implantation of an implantable cardioverter defibrillator (ICD) is currently recommended after the occurrence of sustained monomorphic ventricular tachycardia in patients with structural heart disease whether the arrhythmia is tolerated or not, even in the presence of normal or near-normal ventricular systolic function. The published data and data from the author’s group suggest that in lower-risk patients presenting with stable, monomorphic, scar-related ventricular tachycardia and a left ventricular ejection fraction greater than 35%, an alternative strategy with primary catheter ablation and deferred ICD implantation may be the preferred approach. Scar visualization using cardiovascular magnetic resonance imaging, high-resolution mapping, and better risk stratification after successful catheter ablation of ventricular tachycardia may further help to select the low-risk patients who would not need an ICD after catheter ablation for secondary prevention.
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