Treatment of ventricular tachycardia: consider ablation sooner

Ventricular tachycardia (VT) is a leading cause of morbidity and mortality for many patients, with a significant emotional and economic burden caused by implantable cardioverter-defibrillator (ICD) shocks and the requirement of medication with significant side effects. Additionally, 10% of VT occurs in patients with no structural heart disease. Until quite recently, ablation for VT has been reserved as the procedure of last hope for those who have ongoing recurrences despite maximal medical therapy and who are traumatized by multiple ICD shocks [1]. However, recent advances in imaging technology and three-dimensional intracardiac mapping systems have significantly improved the safety and efficacy of VT ablation procedures. Thus, ablation for VT should no longer be reserved as a last-resort bailout procedure and should move into the realm of routine electrophysiology treatment.