Catheter Ablation for Scar-related Ventricular Tachycardias

Patients with scar-related ventricular tachycardia (VT) are subject to frequent arrhythmia recurrences; antiarrhythmic drug therapy has been disappointing due to poor efficacy and side effects. Patients receiving multiple implantable cardioverter-defibrillator shocks because of VT have impaired quality of life. The role of catheter ablation in the treatment of ventricular arrhythmias has been increasing in the last 2 decades. As more knowledge is gained about the mechanisms of VT, the potential for doing ablation has increased. Now, multiple VTs and unstable VTs can be targeted by ablation strategies. Also, electroanatomic mapping systems have made substrate mapping feasible. The purpose of this article is to review the selection and preparation of patients who require catheter ablation for scar-related VT, the different mapping techniques, and the ablation strategies employed. An overview of the pathophysiology of scar-related VT and the variety of heart diseases that are related to scar-related VT is provided.