Ventricular Arrhythmias in Heart Failure Patients

Ventricular arrhythmia represents a significant cause of mortality and morbidity. Its pathophysiologic mechanisms and electroanatomic substrates are slowly being elucidated. Clinical management in patients with heart failure has progressed from antiarrhythmic drugs to device therapy. Catheter ablation is an effective adjunct in the management of ventricular arrhythmia but remains a significant challenge. Advances in robotic and magnetic catheter manipulation may shorten procedural time and increase safety. Incorporation of imaging technologies such as CT, MRI, or ultrasound with electroanatomic mapping can enhance the ability to map and ablate ventricular arrhythmia. Novel imaging modalities may provide rapid characterization of the substrate for ventricular dysfunction and arrhythmia development and the capacity for serial assessment of the disease progression, improving risk stratification for ventricular dysfunction and arrhythmia development and the capacity for serial assessment of the disease progression, improving risk stratification.