Author + information
- Received September 25, 2017
- Revision received October 11, 2017
- Accepted October 17, 2017
- Published online December 4, 2017.
- Srinivas R. Dukkipati, MD,
- Jacob S. Koruth, MD,
- Subbarao Choudry, MD,
- Marc A. Miller, MD,
- William Whang, MD and
- Vivek Y. Reddy, MD∗ ()
- Helmsley Electrophysiology Center, Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York
- ↵∗Address for correspondence:
Dr. Vivek Y. Reddy, Icahn School of Medicine at Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1030, New York, New York 10029.
In contrast to ventricular tachycardia (VT) that occurs in the setting of a structurally normal heart, VT that occurs in patients with structural heart disease carries an elevated risk for sudden cardiac death (SCD), and implantable cardioverter-defibrillators (ICDs) are the mainstay of therapy. In these individuals, catheter ablation may be used as adjunctive therapy to treat or prevent repetitive ICD therapies when antiarrhythmic drugs are ineffective or not desired. However, certain patients with frequent premature ventricular contractions (PVCs) or VT and tachycardiomyopathy should be considered for ablation before ICD implantation because left ventricular function may improve, consequently decreasing the risk of SCD and obviating the need for an ICD. The goal of this paper is to review the pathophysiology, mechanism, and management of VT in the setting of structural heart disease and discuss the evolving role of catheter ablation in decreasing ventricular arrhythmia recurrence.
Dr. Dukkipati has received a research grant from Biosense Webster. Dr. Koruth has served as a consultant for Biosense Webster and Abbott. Dr. Reddy has received research grants from and served as a consultant for Biosense Webster, Boston Scientific, and Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Roderick Tung, MD, served as Guest Editor for this paper.
- Received September 25, 2017.
- Revision received October 11, 2017.
- Accepted October 17, 2017.
- 2017 American College of Cardiology Foundation