Recent therapeutic strategy for sustained ventricular tachycardia in Japan

We investigated the therapeutic principles and strategies to treat sustained ventricular tachycardia (SVT) as five leading medical institutions in the Tokyo area and summarized the present situation of SVT treatment in Japan. Catheter ablation (ABL) has been almost established to be effective in idiopathic ventricular tachycardia (IVT) and was used as the last treatment in 60.3% of IVTs in this series. ABL may be the first option of therapy for IVT. In patients with SVT who have underlying cardiac diseases, the last treatment was class I drugs in 8.3%, class III drugs in 34.3%, combination drug therapy in 24.0%, ABL in 33.3%, surgical therapy (SUR) in 7.3%, and implantable cardioverter defibrillator (ICD) in 12.5% (nonpharmacological therapy in combination with other therapy). The use of class I drugs was not common, whereas class III drugs were used more frequently in patients with a low left ventricular ejection fraction. In some patients with reduced cardiac function, a combination of class III drugs and non-pharmacological therapy is appropriate.