Emami Mehrdad, Morton Joseph B, Chan Kim H, Roberts-Thomson Kurt C
Centre for Heart Rhythm Disorders, University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia.
University of Melbourne and the Royal Melbourne Hospital, Melbourne, Vic, Australia.
Heart Lung Circ. 2019 Jan;28(1):76-83. doi: 10.1016/j.hlc.2018.10.003. Epub 2018 Oct 15.
Ventricular arrhythmias are one of the leading causes of death in patients with a prior myocardial infarction. Implantable cardioverter-defibrillators (ICDs) are very effective in the prevention of sudden cardiac death but the risk of recurrence remains an issue since defibrillation does not alter the underlying substrate. Recurrent ICD shocks are distressing and are associated with an increase in mortality. Catheter ablation is an effective treatment for recurrent ventricular tachycardia in these patients, particularly when antiarrhythmic therapy produces side effects or is ineffective. This paper reviews the underlying mechanisms of VT in patients with a prior myocardial infarction, and the indications, strategies and outcomes of catheter ablation.