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Targeting Ventricular Arrhythmias in Non-Ischemic Patients: Advances in Diagnosis and Treatment
Laura Adina Stanciulescu1,2, Maria Dorobantu3, Radu Vatasescu1,2
1Department of Cardiothoracic Pathology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 050474 Bucharest, Romania.
Abstract:
Ventricular arrhythmias (VAs) in non-ischemic cardiomyopathy (NICM) present significant clinical challenges due to their diverse etiologies and complex arrhythmogenic substrates, which differ from those in ischemic heart disease. Recent advancements in imaging, electrophysiological mapping, and ablative therapy have improved the management of these arrhythmias. This review examines the spectrum of NICM subtypes, discussing their pathophysiology, prevalence, genetic determinants, and associated arrhythmias. It also explores contemporary ablative techniques, including epicardial, bipolar, and irrigated approaches, as well as emerging modalities such as stereotactic body radiation therapy (SBRT). The role of novel technologies, including high-resolution mapping and artificial intelligence, is considered in refining diagnosis and treatment. This article provides a comprehensive overview of current management strategies and discusses future directions in the treatment of VAs in NICM patients.
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