The new consensus statement offers guidance on a range of issues including:
Indications for catheter ablation of ventricular tachycardia
Technical aspects such as mapping systems, robotic navigation, imaging, energy sources for ablation, anticoagulation and arrhythmic drug management
Mechanisms of specific types of VTs
Ablation outcomes and considerations in specific diseases
Ablation approaches and outcomes for idiopathic VTs that are not due to structural heart disease
Training, institutional requirements and competencies for centers and physicians performing ablation
Clinical trial considerations and needs for future research
The European Heart Rhythm Association and the Heart Rhythm Society created a task force of international experts to conduct rigorous analysis of the available data documenting indications, techniques, benefits and risks and outcomes to produce guidance to improve the effectiveness of care, optimize patient outcomes and identify areas for improvement and future research. The statement summarizes the opinion of the task force members based on their analysis of the literature, as well as their experience in treating patients, and is directed to all health care professionals, health care institutions, manufacturers and governmental, reimbursement and regulatory bodies who are involved in the care of patients with VTs.
Ventricular tachycardia (VT) is characterized by a very fast heart rate and is usually seen in the setting of other serious heart disease, where it can cause cardiac arrest and sudden death. Many patients are protected from death by implanted defibrillators, but these devices do not prevent episodes of VT. Ablation can have a major impact to reduce or prevent VT episodes. VT occurs less frequently in patients without structural heart disease, in whom ablation is often effective sole therapy when treatment is required.
“As the field progresses, it is important that the medical profession plays a significant role in critically evaluating therapies as they are introduced and evolve,” said Etienne Aliot, MD, from Hôpital de Brabois in Vandoeuvre-les-Nancy, France, and co-chair of the task force. “In the past ablation was often not considered until pharmacological options had been exhausted, and often patients had suffered from recurrent episodes of VT and multiple ICD shocks. Based on available studies, experts now affirm that catheter ablation should be considered as an earlier treatment.”
“When considering catheter ablation treatment, physicians should take into account the risks and benefits that are determined by patient characteristics, as well as the availability of appropriate facilities with technical expertise,” said William Stevenson, MD, from Brigham and Women’s Hospital in Boston, Massachusetts, and co-chair of the task force. “This consensus statement defines the indications, techniques and outcomes of catheter ablation procedure specific for the treatment of VT.”
