[High frequency current catheter ablation in ventricular tachycardia].

Since its introduction into clinical practice in 1982, catheter ablation has evolved as a first-line mode of non-pharmacological therapy in patients with atrioventricular nodal reentrant tachycardia and in patients with atrioventricular tachycardia involving an accessory pathway. The initial experience was based on the use of direct current for ablative purposes. However, since severe complications have been observed using this energy source, radiofrequency (RF) current catheter ablation is now the most frequently used technique. Efficacy rates are high (> 80%) in patients with idiopathic ventricular tachycardia and bundle-branch reentrant tachycardia. In addition, the technique also has a relatively high acute success-rate in patients with incessant ventricular tachycardia. However, RF current catheter ablation is less effective in patients with drug-resistant, chronic, sustained ventricular tachycardia after myocardial infarction or in the presence of dilated cardiomyopathy. Further improvements which include new criteria for the localization of the origin of ventricular tachycardia as well as technical improvements are particularly needed in this subgroup of patients. Thus, RF current catheter ablation in patients with ventricular tachycardia can be considered a promising new mode of non-pharmacological therapy. The efficacy rate of the procedure is highly dependent on the presence and type of organic heart disease as well as the mechanisms underlying ventricular tachycardia. Due to the limited experience, especially with respect to the long-term results, RF current catheter ablation is still an experimental mode of antiarrhythmic treatment.