Ventricular tachycardia ablation in non-ischemic cardiomyopathy: a Sisyphean task?

Abstract

Prompt access to reperfusion therapy and the increasing number of treatment options for heart failure (HF) patients have led to decreased HF hospitalizations and improved survival. Nonetheless, incident ventricular arrhythmias (VAs) remain a significant issue where medical therapy is lacking, leading to an expanding population of implantable cardioverter-defibrillator recipients who may experience recurrent VAs. In such cases, ablation of ventricular tachycardia (VT) is effective in suppressing the underlying arrhythmogenic substrate. Initial high rates of adverse outcomes and treatment failure have been surpassed with technological advances, a better understanding of VA mechanisms, and improved imaging tools, leading to an increasing number of patients undergoing scar-related VT ablation. However, some open questions remain about the end clinical impact of this complex procedure.