EP 101 2020: A Virtual Program for Incoming EP Fellows-Ventricular Tachycardia in Ischemic and Non-Ischemic Cardiomyopathy

Ventricular Tachycardia in Ischemic and Non-Ischemic Cardiomyopathy

Video Transcription

Video Summary

Dr. Wendy Zou discusses ventricular tachycardia (VT) in the setting of structural heart disease, specifically ischemic or non-ischemic cardiomyopathy. She explains that re-entry is the predominant mechanism for VT in these patients, usually due to the presence of scar tissue. Dr. Zou emphasizes the importance of scar tissue and its role in altering conduction properties and allowing for re-entry to occur. She also discusses the historical approaches to treating VT, such as surgically removing scar tissue and revascularization procedures. Dr. Zou then describes the advancements in VT ablation techniques, such as substrate-based mapping and ablation, as well as the use of high-density mapping, bipolar ablation, and altered irrigants to enhance ablation efficacy. She also addresses the challenges of mapping and ablating mid-myocardial substrate, as well as the need for multiple procedures in some patients. Dr. Zou provides examples of mapping techniques and the interpretation of electrograms to guide ablation. She concludes by highlighting the importance of ongoing advancements and collaborations in the field of VT ablation.

Asset Subtitle

Wendy Tzou, MD

Keywords

Ventricular tachycardia

Structural heart disease

Ischemic cardiomyopathy

Non-ischemic cardiomyopathy

Re-entry mechanism

Scar tissue

Conduction properties

VT ablation techniques

Substrate-based mapping