Ventricular Tachycardia Ablation
Are We in a New Age?
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See Article by Vakil et al
Since the first electrocardiographic recordings, ventricular tachycardia (VT) has been associated with both significant morbidity and mortality.1 VT most commonly occurs in the presence of structural heart disease that produces myocardial fibrosis, such as myocardial infarction, nonischemic cardiomyopathy, sarcoidosis, and many other diseases. As such, the prognosis of a patient with VT mainly mirrors the extent of underlying heart disease. The prevalence of coronary artery disease in the US population has been shown to increase with age, reaching 20% in subjects >75 years of age.2 Prior to implantable cardioverter defibrillators, the overall downward trajectory of patients with VT proved insurmountable (and at times accelerated) by antiarrhythmic pharmacological therapies in those with structural heart disease.3
The era of revascularization and neurohormonal blockade has seen significant improvement in long-term morbidity and mortality for patients with heart failure.4 With modern medical therapy, patients are living longer and competing risks begin to emerge. VT remains a shadow in the dark—an ever-present threat that often presents itself during significant clinical deterioration but can …