Advancements in mapping, cardiac imaging, and ablation techniques for the management of ventricular tachycardias

Ventricular tachycardias represent a complex clinical challenge, particularly due to the intricate arrhythmic circuits and diverse substrates found in ischemic and non-ischemic cardiomyopathies. This review explores the significant advancements in mapping, imaging, and ablation technologies that have transformed the management strategies for ventricular arrhythmias. Recent innovations such as pulsed-field ablation and high-resolution imaging modalities like cardiac magnetic resonance and multi-detector computed tomography have refined our approach to ablate ventricular tachycardias. The evolution of surgical and hybrid ablation techniques also highlights an adaptive response to cases unmanageable by conventional interventions. Furthermore, we discuss the integration of new diagnostic tools and detailed substrate analysis, which are pivotal in enhancing procedural outcomes and reducing recurrence. This synthesis of current practices with emerging technologies offers a promising direction toward more effective and personalized management of VT, underlining the need for continuous advancement in both technological capabilities and procedural strategies.