Effects of non-pharmacological interventions on ventricular late potentials

The purpose of the paper is to review the presently available information of the effects of non-pharmacological interventions for the control of drug-refractory ventricular tachyarrhythmias on non-invasively recorded ventricular late potentials. During recent years, non-pharmacological interventions have evolved as an alternative form of treatment to control drug-refractory ventricular tachyarrhythmias. The effects of these non-pharmacological measures on ventricular late potentials are poorly understood. Successful surgical control of ventricular tachycardia often normalizes the signal averaged ECG and may eliminate delayed potentials. Thus, this non-invasive test may be useful in assessing surgical efficacy in subgroups of patients with ventricular tachycardia. However, the clinical value of late potentials in assessing surgical efficacy in the individual case may be limited as the sensitivity and specificity of the loss of late potentials after antitachycardia surgery are low. In addition, the effects of transvenous catheter ablation on ventricular late potentials will be reviewed. The available information suggests that this intervention has little effects on the presence or absence of late potentials. Thus, non-invasive recording of late potentials seems not to be helpful in predicting the acute and long-term efficacy of catheter ablation. In conclusion, changing of the parameters in the signal-averaged QRS complex after antitachycardia surgery may be useful in predicting the efficacy of surgical interventions for drug-refractory ventricular tachycardias in subgroups of patients. However, the sensitivity and predictive accuracy of this test are low, thus limiting its clinical usefulness.