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Expert consensus on catheter ablation of ventricular arrhythmias
Date:5/14/2009

the ventricular myocardium. A prior heart attack is a common cause. The second type concerns those where there is no structural disease, known as idiopathic ventricular arrhythmias.

Ventricular arrhythmias may cause symptoms such as syncope and palpitations, and in the most severe cases, cause cardiac arrest and sudden death. Many patients with ventricular arrhythmias and structural heart disease have implantable defibrillators that terminate VA when they occur, but these episodes may still cause symptoms and in some cases require painful shocks for termination. Catheter ablation has an important role in preventing or reducing recurrent attacks of symptomatic VA in these situations and can be life-saving for patients with incessant arrhythmias.

Most idiopathic VA are benign, but careful evaluation is required to distinguish idiopathic from potentially dangerous VA. Ablation is an important alternative to antiarrhythmic drug therapy in many patients with idiopathic VA.

Catheter ablation, the procedure used to selectively eliminate the cells responsible for the arrhythmia, involves inserting catheters (thin flexible wires) into blood vessels, usually in the groin, and threading them through the blood vessels into the heart ventricle under X-ray guidance.

The next step is for the electrophysiologist to use the catheter to identify the source of the abnormal electrical activity in a procedure known as mapping. Mapping may involve triggering VA, or identifying abnormal areas that contain the substrate for VA based on findings during sinus rhythm. Radiofrequency energy is then applied through the catheter to destroy the abnormal area. Finally, testing is performed to determine if ablation has been sufficient to prevent the VA. The process of "mapping and ablation" continues until the electrical disturbance can no longer be triggered by catheters or no further substrate can be identified.

Recent innovations in catheter
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Contact: ESC Press Office
press@escardio.org
33-492-948-627
European Society of Cardiology
Source:Eurekalert

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