Electrophysiologic mapping and cardiac ablation therapy for prevention of ventricular tachycardia

Sudden cardiac arrest is the leading cause of death in developed countries. The majority of these events are caused by ventricular arrhythmias. While implantable defibrillators are effective in reducing the risk of sudden arrhythmic death, they do not prevent recurrences of arrhythmias. ICD shocks are associated with significant psychological implications and are associated with increased mortality. Antiarrhythmic drugs are also associated with significant morbidity and possibly mortality in patients with structural heart disease. Catheter ablation is a procedure that specifically targets the arrhythmic substrate to prevent ventricular arrhythmias. Given the heterogeneity and complexity of the potential arrhythmic substrate, there has been a tremendous evolution in the field of electrophysiologic mapping as well as in the techniques and tools that can be used to achieve effective elimination of the arrhythmic substrate. This chapter will provide an overview of the current challenges and the potential solutions that evolving technologies are offering.