Related Experiment Video

Updated: Jan 29, 2026

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Published on: January 31, 2019

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Catheter ablation of polymorphic ventricular tachycardia/fibrillation in patients with and without structural heart

Tomofumi Nakamura1, Benjamin Schaeffer2, Shinichi Tanigawa2

  • 1Cardiovascular Division, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Heart Rhythm
|February 3, 2019
PubMed
Abstract

Insights

Catheter ablation for polymorphic ventricular tachycardia (PMVT/VF) can target premature ventricular contractions (PVCs) or myocardial scar. Scar ablation is effective for PMVT/VF in structural heart disease patients, even without identifiable PVCs.

Area of Science:

  • Electrophysiology
  • Cardiology
  • Cardiac Ablation

Background:

  • Catheter ablation for polymorphic ventricular tachycardia and ventricular fibrillation (PMVT/VF) often targets premature ventricular contractions (PVCs).
  • The role of targeting ventricular scar in PMVT/VF ablation is less understood due to limited data.

Purpose of the Study:

  • To compare electrophysiological findings and ablation outcomes in patients with PMVT/VF and structural heart disease (SHD) versus idiopathic ventricular fibrillation (VF).
  • To evaluate the efficacy of targeting ventricular scar in PMVT/VF ablation.

Main Methods:

  • Retrospective review of 32 consecutive patients with recurrent PMVT/VF undergoing catheter ablation.
  • Patients were categorized into idiopathic VF (n=13) and SHD (n=19) groups.
  • Ablation strategies included targeting PVCs, ventricular scar, or both.

Main Results:

  • Myocardial scar was present in 15 of 19 SHD patients.
  • Triggering PVCs originated from scar in 6 patients.
  • Recurrence-free rates were 74% for SHD and 77% for idiopathic VF patients.
  • Patients undergoing scar plus PVC ablation had an 86% recurrence-free rate.

Conclusions:

  • Recurrent PMVT/VF in SHD patients is often associated with myocardial scar, which can serve as the substrate.
  • Substrate ablation targeting scar is a viable treatment option for PMVT/VF, even in the absence of identifiable PVCs.
  • Combined scar and PVC ablation demonstrated high efficacy.
Keywords:
AblationPremature ventricular contractionSubstrateVentricular fibrillationVentricular tachycardia

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