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<p>Sustained ventricular tachycardia (VT) is a potentially life-threatening cardiac arrhythmia with a high clinical and prognostic relevance. They can occur idiopathically in structurally normal hearts as well as in the setting of ischemic and non-ischemic cardiomyopathies. Although implantable cardioverter defibrillators (ICD) reduce the risk of sudden cardiac death, they neither prevent recurrent VTs nor mitigate their negative impact on the quality of life and disease progression. Catheter ablation has evolved into an established treatment option owing to advances in cardiac imaging, mapping techniques and ablation procedures and is now firmly anchored in current clinical guidelines. This review article presents the pathophysiological mechanisms of ventricular arrhythmias and places VT ablation within a&#xa0;broader clinical context. The indications, efficacy and risks of VT ablation as well as the optimal timing of the intervention are discussed. Randomized trials consistently demonstrate a&#xa0;reduction in VT recurrences, ICD shocks and hospitalizations with an acceptable complication rate, while a&#xa0;definitive effect on all-cause mortality has not yet been established. Finally, future developments are addressed, including the integration of high-resolution imaging, alternative and noninvasive ablation approaches as well as neurocardiac and molecular treatment strategies, which pave the way for an increasingly personalized treatment of VTs.</p>

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Ablation ventrikulärer Tachykardien

  • 期刊论文

  • 发表日期：

    2026年2月11日

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  • Micaela Ebert,
  • Sergio Richter

摘要

Sustained ventricular tachycardia (VT) is a potentially life-threatening cardiac arrhythmia with a high clinical and prognostic relevance. They can occur idiopathically in structurally normal hearts as well as in the setting of ischemic and non-ischemic cardiomyopathies. Although implantable cardioverter defibrillators (ICD) reduce the risk of sudden cardiac death, they neither prevent recurrent VTs nor mitigate their negative impact on the quality of life and disease progression. Catheter ablation has evolved into an established treatment option owing to advances in cardiac imaging, mapping techniques and ablation procedures and is now firmly anchored in current clinical guidelines. This review article presents the pathophysiological mechanisms of ventricular arrhythmias and places VT ablation within a broader clinical context. The indications, efficacy and risks of VT ablation as well as the optimal timing of the intervention are discussed. Randomized trials consistently demonstrate a reduction in VT recurrences, ICD shocks and hospitalizations with an acceptable complication rate, while a definitive effect on all-cause mortality has not yet been established. Finally, future developments are addressed, including the integration of high-resolution imaging, alternative and noninvasive ablation approaches as well as neurocardiac and molecular treatment strategies, which pave the way for an increasingly personalized treatment of VTs.