Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Aug 1;21(8):1143-1144.
doi: 10.1093/europace/euz132.

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

Edmond M Cronin  1 , Frank M Bogun  2 , Philippe Maury  3 , Petr Peichl  4 , Minglong Chen  5 , Narayanan Namboodiri  6 , Luis Aguinaga  7 , Luiz Roberto Leite  8 , Sana M Al-Khatib  9 , Elad Anter  10 , Antonio Berruezo  11 , David J Callans  12 , Mina K Chung  13 , Phillip Cuculich  14 , Andre d'Avila  15 , Barbara J Deal  16 , Paolo Della Bella  17 , Thomas Deneke  18 , Timm-Michael Dickfeld  19 , Claudio Hadid  20 , Haris M Haqqani  21 , G Neal Kay  22 , Rakesh Latchamsetty  2 , Francis Marchlinski  12 , John M Miller  23 , Akihiko Nogami  24 , Akash R Patel  25 , Rajeev Kumar Pathak  26 , Luis C Sáenz Morales  27 , Pasquale Santangeli  12 , John L Sapp  28 , Andrea Sarkozy  29 , Kyoko Soejima  30 , William G Stevenson  31 , Usha B Tedrow  32 , Wendy S Tzou  33 , Niraj Varma  13 , Katja Zeppenfeld  34 ; ESC Scientific Document Group
Collaborators, Affiliations

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

Edmond M Cronin et al. Europace. .

Erratum in

Abstract

Ventricular arrhythmias are an important cause of morbidity and mortality and come in a variety of forms, from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. Rapid developments have taken place over the past decade in our understanding of these arrhythmias and in our ability to diagnose and treat them. The field of catheter ablation has progressed with the development of new methods and tools, and with the publication of large clinical trials. Therefore, global cardiac electrophysiology professional societies undertook to outline recommendations and best practices for these procedures in a document that will update and replace the 2009 EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias. An expert writing group, after reviewing and discussing the literature, including a systematic review and meta-analysis published in conjunction with this document, and drawing on their own experience, drafted and voted on recommendations and summarized current knowledge and practice in the field. Each recommendation is presented in knowledge byte format and is accompanied by supportive text and references. Further sections provide a practical synopsis of the various techniques and of the specific ventricular arrhythmia sites and substrates encountered in the electrophysiology lab. The purpose of this document is to help electrophysiologists around the world to appropriately select patients for catheter ablation, to perform procedures in a safe and efficacious manner, and to provide follow-up and adjunctive care in order to obtain the best possible outcomes for patients with ventricular arrhythmias.

Keywords: Catheter ablation; Clinical document; Electrical storm; Electroanatomical mapping; Electrocardiogram; Expert consensus statement; Imaging; Premature ventricular complex; Radiofrequency ablation; Ventricular arrhythmia; Ventricular tachycardia.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Monomorphic (A), pleomorphic (B), and polymorphic (C) VT. Reproduced with permission of the Heart Rhythm Society (S2.3.1). VT = ventricular tachycardia.
Figure 2
Figure 2
Congenital heart disease and sustained VT. For further discussion of ICD candidacy, please see PACES/HRS Expert Consensus Statement on the Recognition and Management of Arrhythmias in Adult Congenital Heart Disease (S4.7.14) and 2012 ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities (S4.7.30). ACA = aborted cardiac arrest; CHD = congenital heart disease; DORV = double outlet right ventricle; ICD = implantable cardioverter defibrillator; TOF = tetralogy of Fallot; VT = ventricular tachycardia.
Figure 3
Figure 3
Examples of 12-lead ECGs of premature ventricular complexes from different LV sites, as corroborated by successful focal ablation. (A) shows 12-lead ECG patterns of common ventricular arrhythmia origins in patients without SHD [1–9] from the left ventricle. All leads are displayed at the same amplification and sweep speed. These locations are illustrated in (B) based on 3D reconstruction of a cardiac computed tomography using the MUSIC software that was developed at the University of Bordeaux. The reconstruction shows an anterolateral view of the left ventricle, aorta, and left atrium. Also shown are the coronary arteries (red), the coronary venous system (blue), and the phrenic nerve (green). AIV = anterior interventricular vein; AL PAP = anterolateral papillary muscle; AMC = aortomitral continuity; GCV = great cardiac vein; ant. MA = anterior mitral valve annulus; PM PAP = posteromedial papillary muscle; R/L = right-left; SHD = structural heart disease; SoV = sinus of Valsalva.
Figure 4
Figure 4
Examples of 12-lead ECGs of premature ventricular complexes from different right ventricular sites, as corroborated by successful focal ablation. All leads are displayed at the same amplification and sweep speed. (A) shows the 12-lead ECG pattern of common origins of right ventricular arrhythmias in patients without SHD [1–6]. The locations are detailed in a 3D reconstruction of the computed tomography using the MUSIC software that was developed at the University of Bordeaux. The reconstruction shown in (B) illustrates the septal view of the right ventricle. Indicated are the pulmonary artery, the tricuspid valve annulus, and the right ventricular apex. ECGs = electrocardiograms; PA = pulmonary artery; RVOT= right ventricular outflow tract; SHD = structural heart disease; TVA = tricuspid valve annulus.
Figure 5
Figure 5
Entrainment responses from components of reentrant VT circuit. CL = cycle length; PPI = postpacing interval; VT = ventricular tachycardia.
Figure 6
Figure 6
Pacing from the protected isthmus of a VT circuit. Entrainment mapping during VT. The VT CL is 620 ms, and pacing is performed at a CL of 580 ms. A low-voltage electrogram is located in diastole on the recordings of the ablation catheter (Map). The stimulus-QRS interval is 230 ms and matches with the electrogram-QRS interval. The postpacing interval (PPI) is equal to the VT CL. The stimulus-QRS/VT CL ratio is 0.37, indicating that the catheter is located in the common pathway. CL = cycle length; PPI = postpacing interval; VT = ventricular tachycardia.
Figure 7
Figure 7
Anatomical boundaries of the LV summit, with the inaccessible [1] and accessible [2] parts. Shown are the left anterior descending artery (LAD), the circumflex artery (Cx), the great cardiac vein (GCV), the anterior interventricular vein (AIV) and the first and second diagonal branch of the LAD (D1, D2).
Figure 8
Figure 8
Intraprocedural imaging during ablation of papillary muscle arrhythmias. (A): Anatomical map of the left ventricle (CARTO, Biosense Webster) showing contact of the ablation catheter (Abl) with the posteromedial papillary muscle (PMPAP). (B): Intracardiac echocardiogram showing real-time visualization of the ablation catheter during ablation on the anterolateral papillary muscle (ALPAP).
Figure 9
Figure 9
Overview of the workflow for catheter ablation of VT in patients with IHD. Not all of these steps might be required, and steps can be performed in a different sequence. For instance, repeat VT induction can be deferred in patients with hemodynamic instability. In addition, the operator might have to adapt to events that arise during the case, for instance, to take advantage of spontaneous initiation of stable VT during substrate mapping and switch to activation mapping. IHD = ischemic heart disease; PES= programmed electrical stimulation; SR = sinus rhythm; VT = ventricular tachycardia.
Figure 10
Figure 10
Epicardial substrate ablation in a patient with Brugada syndrome and appropriate ICD shocks for VF. Image integration of a preacquired CT with the electroanatomical epicardial substrate map is shown in (A). Purple represents bipolar voltage >1.5 mV. Fractionated potentials (arrows) are tagged with black dots, and a representative example is displayed. Widespread fractionated potentials were recorded from the epicardial aspect of the RVOT extending down into the basal RV body. Ablation lesions are tagged with red dots. Some fractionated potentials could not be ablated due to the proximity of the acute marginal branches of the right coronary artery. Panel (B) shows the significant transient accentuation of the Brugada ECG pattern during the application of radiofrequency energy at one of these sites. CT = computed tomography; ECG = electrocardiogram; ICD = implantable cardioverter defibrillator; PA = pulmonary artery; RA = right atrium; RCA = right coronary artery; RFA = radiofrequency ablation; RV = right ventricle; RVOT = right ventricular outflow tract; VF = ventricular fibrillation.
Figure 11
Figure 11
Right ventricular voltage maps from cases of moderate (upper row) and advanced (lower row) arrhythmogenic right ventricular cardiomyopathy (ARVC) are shown. Purple represents a voltage >1.5 mV in the bipolar maps (left and right) and >5.5 mV in the unipolar maps (center); red represents a voltage <0.5 mV in the bipolar maps and <3.5 mV in the unipolar maps. Moderate ARVC is defined as having a bipolar/unipolar low-voltage area ratio of <0.23 and is associated with epicardial arrhythmogenic substrate area (ASA) (defined by the presence of electrograms with delayed components of >10 cm2). Advanced ARVC displays a bipolar/unipolar endocardial low-voltage area of ≥0.23, which is associated with an epicardial arrhythmogenic substrate area of ≤10 cm2 (S9.10.4.5). Adapted with permission from Oxford University Press (S9.10.4.5).
Figure 12
Figure 12
Anatomical isthmuses (AI) in repaired tetralogy of Fallot according to the surgical approach and variation of the malformation. RV = right ventricle; TA = tricuspid annulus; VSD = ventricular septal defect.
Figure 13
Figure 13
Factors influencing outcomes post VA ablation. ICD = implantable cardioverter defibrillator; LVAD = left ventricular assist device; VA = ventricular arrhythmia; VT = ventricular tachycardia.
See this image and copyright information in PMC

References

1 Introduction

    1. Aliot EM, Stevenson WG, Almendral-Garrote JM, et al.EHRA/HRS expert consensus on catheter ablation of ventricular arrhythmias: developed in a partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC), and the Heart Rhythm Society (HRS); in collaboration with the American College of Cardiology (ACC) and the American Heart Association (AHA). Heart Rhythm 2009; 6:886–933. - PubMed
    1. Hosseini SM, Rozen G, Saleh A, et al.Catheter ablation for cardiac arrhythmias: utilization and in-hospital complications, 2000 to 2013. JACC Clin Electrophysiol 2017;3:1240–1248. - PubMed
    1. Raatikainen MJP, Arnar DO, Merkely B, Nielsen JC, Hindricks G, Heidbuchel H, Camm J. A decade of information on the use of cardiac implantable electronic devices and interventional electrophysiological procedures in the European Society of Cardiology Countries: 2017 report from the European Heart Rhythm Association. Europace 2017;19(Suppl. 2):ii1–ii90. - PubMed
    1. Al-Khatib SM, Stevenson WG, Ackerman MJ, et al.2017AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/ American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm 2018;15:e73–e189. - PubMed
    1. Priori SG, Blomström-Lundqvist C, Mazzanti A, et al.; Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). 2015 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: the Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Europace 2015;17:1601–1687. - PubMed

1.2 Methods

    1. Indik JH, Patton KK, Beardsall M, et al.HRS clinical document development methodology manual and policies: executive summary. Heart Rhythm 2017; 14:e495–e500. - PubMed
    1. Halperin JL, Levine GN, Al-Khatib SM, et al.Further evolution of the ACC/ AHA clinical practice guideline recommendation classification system: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2016; 67:1572–1574. - PubMed
    1. Martinez BK, Baker WL, Konopka A, et al.Systematic review and metaanalysis of catheter ablation of ventricular tachycardia in ischemic heart disease. Heart Rhythm 2019 May 10. [Epub ahead of print]. - PubMed

2.1 History of Ventricular Arrhythmia Ablation

    1. Couch OA Jr. Cardiac aneurysm with ventricular tachycardia and subsequent excision of aneurysm. Circulation 1959;20:251–253. - PubMed
    1. Mason JW, Stinson EB, Winkle RA, et al.Relative efficacy of blind left ventricular aneurysm resection for the treatment of recurrent ventricular tachycardia. Am J Cardiol 1982;49:241–248. - PubMed
    1. Guiraudon G, Fontaine G, Frank R, et al.Encircling endocardial ventriculotomy: a new surgical treatment for life-threatening ventricular tachycardias resistant to medical treatment following myocardial infarction. Ann Thorac Surg 1978;26:438–444. - PubMed
    1. Guiraudon G, Klein GJ, Gulamhusein S, et al.Total disconnection of the right ventricular free wall: surgical treatment of right ventricular tachycardia associated with right ventricular dysplasia. Circulation 1983; 67:463–470. - PubMed
    1. Josephson ME, Harken AH, Horowitz LN. Endocardial excision: a new surgical technique for the treatment of recurrent ventricular tachycardia. Circulation 1979;60:1430–1439. - PubMed

2.2.4 Reentry in the Purkinje System and Ventricular Fibrillation

    1. Buxton AE, Waxman HL, Marchlinski FE, Simson MB, Cassidy D, Josephson ME. Right ventricular tachycardia: clinical and electrophysiologic characteristics. Circulation 1983;68:917–927. - PubMed
    1. Lerman BB. Response of nonreentrant catecholamine-mediated ventricular tachycardia to endogenous adenosine and acetylcholine: evidence for myocardial receptor-mediated effects. Circulation 1993;87:382–390. - PubMed
    1. Lerman BB, Belardinelli L, West GA, Berne RM, DiMarco JP. Adenosine- sensitive ventricular tachycardia: evidence suggesting cyclic AMPmediated triggered activity. Circulation 1986;74:270–280. - PubMed
    1. Lerman BB, Stein K, Engelstein ED, et al.Mechanism of repetitive monomorphic ventricular tachycardia. Circulation 1995;92:421–429. - PubMed
    1. Sung RJ, Keung EC, Nguyen NX, Huycke EC. Effects of beta-adrenergic blockade on verapamil-responsive and verapamil-irresponsive sustained ventricular tachycardias. J Clin Invest 1988;81:688–699. - PMC - PubMed

2.3 Definitions

    1. Aliot EM, Stevenson WG, Almendral-Garrote JM, et al.EHRA/HRS expert consensus on catheter ablation of ventricular arrhythmias: developed in a partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC), and the Heart Rhythm Society (HRS); in collaboration with the American College of Cardiology (ACC) and the American Heart Association (AHA). Heart Rhythm 2009; 6:886–933. - PubMed
    1. Crosson JE, Callans DJ, Bradley DJ, et al.PACES/HRS expert consensus statement on the evaluation and management of ventricular arrhythmias in the child with a structurally normal heart. Heart Rhythm 2014; 11:e55–e78. - PubMed

2.4 Standard Anatomic Terminology

    1. Yamada T, Kay GN. Anatomical consideration in catheter ablation of idiopathic ventricular arrhythmias. Arrhythm Electrophysiol Rev 2016;5:203–209. - PMC - PubMed
    1. Della Bella P, Maccabelli G, Carbucicchio C. Anatomical assessment for catheter ablation of ventricular tachycardia. In: Auricchio A, ed. Cardiac Imaging in Electrophysiology. London: Springer-Verlag; 2012, p. 95–104.
    1. Enriquez A, Malavassi F, Saenz LC, Supple G, Santangeli P, Marchlinski FE, Garcia FC. How to map and ablate left ventricular summit arrhythmias. Heart Rhythm 2017;14:141–148. - PubMed
    1. Saremi F, Muresian H, Sanchez-Quintana D. Coronary veins: comprehensive CT-anatomic classification and review of variants and clinical implications. Radiographics 2012;32:E1–E32. - PubMed
    1. Ho SY. Anatomic insights for catheter ablation of ventricular tachycardia. Heart Rhythm 2009;6(Suppl. 8):S77–S80. - PubMed

3.1 Clinical Presentation

    1. Al-Khatib SM, Stevenson WG, Ackerman MJ, et al.2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/ American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm 2018;15:e73–e189. - PubMed
    1. Shen WK, Sheldon RS, Benditt DG, et al.2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2017;70:e39–e110. - PubMed
    1. Yarlagadda RK, Iwai S, Stein KM, et al.Reversal of cardiomyopathy in patients with repetitive monomorphic ventricular ectopy originating from the right ventricular outflow tract. Circulation 2005;112:1092–1097. - PubMed
    1. Agarwal V, Vittinghoff E, Whitman IR, Dewland TA, Dukes JW, Marcus GM. Relation between ventricular premature complexes and incident heart failure. Am J Cardiol 2017;119:1238–1242. - PubMed
    1. Heidbüchel H, Tack J, Vanneste L, Ballet A, Ector H, Van de Werf F. Significance of arrhythmias during the first 24 hours of acute myocardial infarction treated with alteplase and effect of early administration of a beta-blocker or a bradycardiac agent on their incidence. Circulation 1994;89:1051–1059. - PubMed

3.2.1 Resting 12-Lead Electrocardiogram

    1. Brugada P, Brugada J, Mont L, Smeets J, Andries EW. A new approach to the differential diagnosis of a regular tachycardia with a wide QRS complex. Circulation 1991;83:1649–1659. - PubMed
    1. Wellens HJ, Bar FW, Lie KI. The value of the electrocardiogram in the differential diagnosis of a tachycardia with a widened QRS complex. Am J Med 1978;64:27–33. - PubMed
    1. Vereckei A, Duray G, Szenasi G, Altemose GT, Miller JM. New algorithm using only lead aVR for differential diagnosis of wide QRS complex tachycardia. Heart Rhythm 2008;5:89–98. - PubMed
    1. Ohe T, Shimomura K, Aihara N, et al.Idiopathic sustained left ventricular tachycardia: clinical and electrophysiologic characteristics. Circulation 1988;77:560–568. - PubMed
    1. Dixit S, Gerstenfeld EP, Callans DJ, Marchlinski FE Electrocardiographic patterns of superior right ventricular outflow tract tachycardias: distinguishing septal and free-wall sites of origin. J Cardiovasc Electrophysiol 2003;14:1–7. - PubMed

3.2.2 Assessment of Structural Heart Disease and Myocardial Ischemia

    1. Solomon SD, Zelenkofske S, McMurray JJ, et al.Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure, or both. N Engl J Med 2005;352:2581–2588. - PubMed
    1. Gula LJ, Klein GJ, Hellkamp AS, et al.Ejection fraction assessment and survival: an analysis of the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). Am Heart J 2008;156:1196–1200. - PMC - PubMed
    1. Yoon Y, Ktagawa K, Kato S, et al.Prognostic value of unrecognised myocardial infarction detected by late gadolinium-enhanced MRI in diabetic patients with normal global and regional left ventricular systolic function. Eur Radiol 2013;23:2101–2108. - PubMed
    1. Olivotto I, Maron M, Autore C, et al.Assessment and significance of left ventricular mass by cardiovascular magnetic resonance in hypertrophic cardiomyopathy. J Am Coll Cardiol 2008;52:559–566. - PubMed
    1. Desjardins B, Yokokawa M, Good E, et al.Characteristics of intramural scar in patients with nonischemic cardiomyopathy and relation to intramural ventricular arrhythmias. Circ Arrhythm Electrophysiol 2013;6:891–897. - PubMed

3.2.3 Risk Stratification in the Setting of Frequent Premature Ventricular Complexes

    1. Aquaro GD, Pingitore A, Strata E, Di Bella G, Molinaro S, Lombardi M. Cardiac magnetic resonance predicts outcome in patients with premature ventricular complexes of left bundle branch block morphology. J Am Col Cardiol 2010;56:1235–1243. - PubMed
    1. Yokokawa M, Siontis KC, Kim HM, et al.Value of cardiac magnetic resonance imaging and programmed ventricular stimulation in patients with frequent premature ventricular complexes undergoing radiofrequency ablation. Heart Rhythm 2017;14:1695–1701. - PubMed
    1. Scott PA, Rosengarten JA, Curzen NP, Morgan JM. Late gadolinium enhancement cardiac magnetic resonance imaging for the prediction of ventricular tachyarrhythmic events: a meta-analysis. Eur J Heart Fail 2013;15:1019–1027. - PubMed
    1. Kuruvilla S, Adenaw N, Katwal AB, Lipinski MJ, Kramer CM, Salerno M Late gadolinium enhancement on cardiac magnetic resonance predicts adverse cardiovascular outcomes in nonischemic cardiomyopathy: a systematic review and meta-analysis. Circ Cardiovasc Imaging 2014; 7:250–258. - PMC - PubMed
    1. Di Marco A, Anguera I, Schmitt M, et al.Late gadolinium enhancement and the risk for ventricular arrhythmias or sudden death in dilated cardiomyopathy: systematic review and meta-analysis. JACC Heart Fail 2017; 5:28–38. - PubMed

3.2.4 Longitudinal Follow-up in the Setting of Frequent Premature Ventricular Complexes

    1. Niwano SY, Wakisaka H, Niwano H, et al.Prognostic significance of frequent premature ventricular contractions originating from the ventricular outflow tract in patients with normal left ventricular function. Heart 2009; 95:1230–1237. - PubMed
    1. Baman TS, Lange DC, Ilg KJ, et al.Relationship between burden of premature ventricular complexes and left ventricular function. Heart Rhythm 2010;7:865–869. - PubMed

4 Indications for Catheter Ablation

    1. Halperin JL, Levine GN, Al-Khatib SM, et al.Further evolution of the ACC/ AHA clinical practice guideline recommendation classification system: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2016; 133:1426–1428. - PubMed
    1. Al-Khatib SM, Stevenson WG, Ackerman MJ, et al.2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm 2018; 15:e73–e189. - PubMed

4.1 Idiopathic Outflow Tract Ventricular Arrhythmia

    1. Ling Z, Liu Z, Su L, et al.Radiofrequency ablation versus antiarrhythmic medication for treatment of ventricular premature beats from the right ventricular outflow tract: prospective randomized study. Circ Arrhythm Electrophysiol 2014;7:237–243. - PubMed
    1. Zhang F, Yang B, Chen H, Ju W, Kojodjojo P, Cao K, Chen M. Magnetic versus manual catheter navigation for mapping and ablation of right ventricular outflow tract ventricular arrhythmias: a randomized controlled study. Heart Rhythm 2013;10:1178–1183. - PubMed
    1. Krittayaphong R, Sriratanasathavorn C, Dumavibhat C, et al.Electrocardiographic predictors of long term outcomes after radiofrequency ablation in patients with right-ventricular outflow tract tachycardia. Europace 2006; 8:601–606. - PubMed
    1. Vestal M, Wen MS, Yeh SJ, Wang CC, Lin FC, Wu D. Electrocardiographic predictors of failure and recurrence in patients with idiopathic right ventricular outflow tract tachycardia and ectopy who underwent radiofrequency catheter ablation. J Electrocardiol 2003;36:327–332. - PubMed
    1. Miyazawa K, Ueda M, Kondo Y, Hayashi T, Nakano M, Ishimura M, Nakano M, Kobayashi Y. Rapid mapping and differentiation in ventricular outflow tract arrhythmia using non-contact mapping. J Interv Card Electrophysiol 2017;49:41–49. - PubMed

4.2 Idiopathic Nonoutflow Tract Ventricular Arrhythmias

    1. Van Herendael H, Garcia F, Lin D, et al.Idiopathic right ventricular arrhythmias not arising from the outflow tract: prevalence, electrocardiographic characteristics, and outcome of catheter ablation. Heart Rhythm 2011;8:511–518. - PubMed
    1. Sadek MM, Benhayon D, Sureddi R, et al.Idiopathic ventricular arrhythmias originating from the moderator band: electrocardiographic characteristics and treatment by catheter ablation. Heart Rhythm 2015;12:67–75. - PubMed
    1. Crawford T, Mueller G, Good E, et al.Ventricular arrhythmias originating from papillary muscles in the right ventricle. Heart Rhythm 2010;7:725–730. - PubMed
    1. Tada H, Tadokoro K, Miyaji K, et al.Idiopathic ventricular arrhythmias arising from the pulmonary artery: prevalence, characteristics, and topography of the arrhythmia origin. Heart Rhythm 2008;5:419–426. - PubMed
    1. Tada H, Tadokoro K, Ito S, et al.Idiopathic ventricular arrhythmias originating from the tricuspid annulus: prevalence, electrocardiographic characteristics, and results of radiofrequency catheter ablation. Heart Rhythm 2007;4:7–16. - PubMed

4.3 Premature Ventricular Complexes With or Without Left Ventricular Dysfunction

    1. Latchamsetty RY, Morady M, Kim F, et al.Multicenter outcomes for catheter ablation of idiopathic premature ventricular complexes. JACC Clinical Electrophysiol 2015;1:116–123. - PubMed
    1. Singh SN, Fletcher RD, Fisher SG, et al.Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia: survival trial of antiarrhythmic therapy in congestive heart failure. N Engl J Med 1995;333:77–82. - PubMed
    1. Mountantonakis SE, Frankel DS, Gerstenfeld EP, et al.Reversal of outflow tract ventricular premature depolarization-induced cardiomyopathy with ablation: effect of residual arrhythmia burden and preexisting cardiomyopathy on outcome. Heart Rhythm 2011;8:1608–1614. - PubMed
    1. Zang M, Zhang T, Mao J, Zhou S, He B. Beneficial effects of catheter ablation of frequent premature ventricular complexes on left ventricular function. Heart 2014;100:787–793. - PubMed
    1. Lee A, Denman R, Haqqani HM. Ventricular ectopy in the context of left ventricular systolic dysfunction: risk factors and outcomes following catheter ablation. Heart Lung Circ 2019;28:379–388. - PubMed

4.4 Ventricular Arrhythmia in Ischemic Heart Disease

    1. Sapp JL, Wells GA, Parkash R, et al.Ventricular tachycardia ablation versus escalation of antiarrhythmic drugs. N Engl J Med 2016;375:111–121. - PubMed
    1. Stevenson WG, Wilber DJ, Natale A, et al.; Multicenter Thermocool VT Ablation Trial Investigators. Irrigated radiofrequency catheter ablation guided by electroanatomic mapping for recurrent ventricular tachycardia after myocardial infarction: the multicenter thermocool ventricular tachycardia ablation trial. Circulation 2008;118:2773–2782. - PubMed
    1. Tanner H, Hindricks G, Volkmer M, et al.Catheter ablation of recurrent scar-related ventricular tachycardia using electroanatomical mapping and irrigated ablation technology: results of the prospective multicenter Euro- VT-study. J Cardiovasc Electrophysiol 2010;21:47–53. - PubMed
    1. Marchlinski FE, Haffajee CI, Beshai JF, et al.Long-term success of irrigated radiofrequency catheter ablation of sustained ventricular tachycardia: postapproval THERMOCOOL VT trial. J Am Coll Cardiol 2016;67:674–683. - PubMed
    1. Carbucicchio C, Santamaria M, Trevisi N, et al.Catheter ablation for the treatment of electrical storm in patients with implantable cardioverter-defibrillators: short- and long-term outcomes in a prospective single-center study. Circulation 2008;117:462–469. - PubMed

4.5 Nonischemic Cardiomyopathy

    1. Muser D, Santangeli P, Castro SA, et al.Long-term outcome after catheter ablation of ventricular tachycardia in patients with nonischemic dilated cardiomyopathy. Circ Arrhythm Electrophysiol 2016;9:e004328. - PubMed
    1. Proietti R, Essebag V, Beardsall J, et al.Substrate-guided ablation of haemodynamically tolerated and untolerated ventricular tachycardia in patients with structural heart disease: effect of cardiomyopathy type and acute success on long-term outcome. Europace 2015;17:461–467. - PubMed
    1. Dinov B, Arya A, Bertagnolli L, et al.Early referral for ablation of scarrelated ventricular tachycardia is associated with improved acute and long-term outcomes: results from the Heart Center of Leipzig ventricular tachycardia registry. Circ Arrhythm Electrophysiol 2014;7:1144–1151. - PubMed
    1. Dinov B, Fiedler L, Schönbauer R, et al.Outcomes in catheter ablation of ventricular tachycardia in dilated nonischemic cardiomyopathy compared with ischemic cardiomyopathy: results from the Prospective Heart Centre of Leipzig VT (HELP-VT) study. Circulation 2014;129:728–736. - PubMed
    1. Tokuda M, Tedrow UB, Kojodjojo P, et al.Catheter ablation of ventricular tachycardia in nonischemic heart disease. Circ Arrhythm Electrophysiol 2012;5:992–1000. - PubMed

4.6 Ventricular Arrhythmia Involving the His-Purkinje System, Bundle Branch Reentrant Tachycardia, and Fascicular Ventricular Tachycardia

    1. Cohen TJ, Chien WW, Lurie KG, et al.Radiofrequency catheter ablation for treatment of bundle branch reentrant ventricular tachycardia: results and long-term follow-up. J Am Coll Cardiol 1991;18:1767–1773. - PubMed
    1. Blank Z, Dhala A, Deshpande S, Sra J, Jazayeri M, Akhtar M. Bundle branch reentrant ventricular tachycardia: cumulative experience in 48 patients. J Cardiovasc Electrophysiol 1993;4:253–262. - PubMed
    1. Mehdirad AA, Keim S, Rist K, Tchou P. Long-term clinical outcome of right bundle branch radiofrequency catheter ablation for treatment of bundle branch reentrant ventricular tachycardia. Pacing Clin Electrophysiol 1995; 18(12 Pt 1):2135–2143. - PubMed
    1. Pathak RK, Fahed J, Santangeli P, et al.Long-term outcome of catheter ablation for treatment of bundle branch re-entrant tachycardia. JACC Clin Electrophysiol 2018;4:331–338. - PubMed
    1. Narasimhan C, Jazayeri MR, Sra J, et al.Ventricular tachycardia in valvular heart disease: facilitation of bundle-branch reentry by valve surgery. Circulation 1997;96:4307–4313. - PubMed

4.7 Congenital Heart Disease

    1. Gatzoulis MA, Till JA, Somerville J, Redington AN. Mechanoelectrical interaction in tetralogy of Fallot. QRS prolongation relates to right ventricular size and predicts malignant ventricular arrhythmias and sudden death. Circulation 1995;92:231–237. - PubMed
    1. Harrison DA, Harris L, Siu SC, et al.Sustained ventricular tachycadia in adult patients late after repair of tetralogy of Fallot. J Am Coll Cardiol 1997;30:1368–1373. - PubMed
    1. Knauth AL, Gauvreau K, Powell AJ, et al.Ventricular size and function assessed by cardiac MRI predict major adverse clinical outcomes late after tetralogy of Fallot repair. Heart 2008;94:211–216. - PubMed
    1. Diller GP, Kempny A, Liodakis E, et al.Left ventricular longitudinal function predicts life-threatening ventricular arrhythmia and death in adults with repaired tetralogy of Fallot. Circulation 2012;125:2440–2446. - PubMed
    1. Koyak Z, Harris L, de Groot JR, et al.Sudden cardiac death in adult congenital heart disease. Circulation 2012;126:1944–1954. - PubMed

4.8 Inherited Arrhythmia Syndromes

    1. Berruezo A, Acosta J, Fernández-Armenta J, et al.Safety, long-term outcomes and predictors of recurrence after first-line combined endoepicardial ventricular tachycardia substrate ablation in arrhythmogenic cardiomyopathy. Impact of arrhythmic substrate distribution pattern. A prospective multicentre study. Europace 2017;19:607–616. - PubMed
    1. Jiang H, Zhang X, Yang Q, et al.Catheter ablation for ventricular tachycardia in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy: a systematic review and meta-analysis. Acta Cardiol 2016;71:639–649. - PubMed
    1. Philips B, te Riele AS, Sawant A, et al.Outcomes and ventricular tachycardia recurrence characteristics after epicardial ablation of ventricular tachycardia in arrhythmogenic right ventricular dysplasia/cardiomyopathy. Heart Rhythm 2015;12:716–725. - PubMed
    1. Santangeli P, Zado ES, Supple GE, et al.Long-termoutcome with catheter ablation of ventricular tachycardia in patients with arrhythmogenic right ventricular cardiomyopathy. Circ Arrhythm Electrophysiol 2015;8:1413–1421. - PubMed
    1. Philips B, Madhavan S, James C, et al.Outcomes of catheter ablation of ventricular tachycardia in arrhythmogenic right ventricular dysplasia/cardiomyopathy. Circ Arrhythm Electrophysiol 2012;5:499–505. - PubMed

4.9 Ventricular Arrhythmia in Hypertrophic Cardiomyopathy

    1. Dukkipati SR, d’Avila A, Soejima K, et al.Long-term outcomes of combined epicardial and endocardial ablation of monomorphic ventricular tachycardia related to hypertrophic cardiomyopathy. Circ Arrhythm Electrophysiol 2011;4:185–194. - PubMed
    1. Santangeli P, Di Biase L, Lakkireddy D, et al.Radiofrequency catheter ablation of ventricular arrhythmias in patients with hypertrophic cardiomyopathy: safety and feasibility. Heart Rhythm 2010;7:1036–1042. - PubMed
    1. Ueda A, Fukamizu S, Soejima K, et al.Clinical and electrophysiological characteristics in patients with sustained monomorphic reentrant ventricular tachycardia associated with dilated-phase hypertrophic cardiomyopathy. Europace 2012;14:734–740. - PubMed
    1. Inada K, Seiler J, Roberts-Thomson KC, et al.Substrate characterization and catheter ablation formonomorphic ventricular tachycardia in patients with apical hypertrophic cardiomyopathy. J Cardiovasc Electrophysiol 2011;22:41–48. - PubMed
    1. Igarashi M, Nogami A, Kurosaki K, et al.Radiofrequency catheter ablation of ventricular tachycardia in patients with hypertrophic cardiomyopathy and apical aneurysm. JACC Clin Electrophysiol 2018;4:339–350. - PubMed

5.1.3 Multidisciplinary Involvement

    1. Della Bella P, Baratto F, Tsiachris D, et al.Management of ventricular tachycardia in the setting of a dedicated unit for the treatment of complex ventricular arrhythmias: long-term outcome after ablation. Circulation 2013;127:1359–1368. - PubMed
    1. Santangeli P, Muser D, Zado ES, et al.Acute hemodynamic decompensation during catheter ablation of scar-related ventricular tachycardia: incidence, predictors, and impact on mortality. Circ Arrhythm Electrophysiol 2015;8:68–75. - PubMed
    1. Santangeli P, Frankel DS, Tung R, et al.Early mortality after catheter ablation of ventricular tachycardia in patients with structural heart disease. J Am Coll Cardiol 2017;69:2105–2115. - PubMed
    1. Tzou WS, Tung R, Frankel DS, et al.Ventricular tachycardia ablation in severe heart failure: an International Ventricular Tachycardia Ablation Center Collaboration analysis. Circ Arrhythm Electrophysiol 2017; 10:e004494. - PubMed
    1. Enriquez A, Liang J, Gentile J, et al.Outcomes of rescue cardiopulmonary support for periprocedural acute hemodynamic decompensation in patients undergoing catheter ablation of electrical storm. Heart Rhythm 2018;15:75–80. - PubMed

5.2.8 Summary

    1. Dixit S, Gerstenfeld EP, Callans DJ, Marchlinski FE Electrocardiographic patterns of superior right ventricular outflow tract tachycardias: distinguishing septal and free-wall sites of origin. J Cardiovasc Electrophysiol 2003;14:1–7. - PubMed
    1. Yamauchi Y, Aonuma K, Takahashi A, et al.Electrocardiographic characteristics of repetitive monomorphic right ventricular tachycardia originating near the His-bundle. J Cardiovasc Electrophysiol 2005; 16:1041–1048. - PubMed
    1. Tanner H, Hindricks G, Schirdewahn P, et al.Outflow tract tachycardia with R/S transition in lead V3: six different anatomic approaches for successful ablation. J Am Coll Cardiol 2005;45:418–423. - PubMed
    1. Ouyang F, Fotuhi P, Ho SY, et al.Repetitive monomorphic ventricular tachycardia originating from the aortic sinus cusp: electrocardiographic characterization for guiding catheter ablation. J Am Coll Cardiol 2002; 39:500–508. - PubMed
    1. Tada H, Ito S, Naito S, et al.Idiopathic ventricular arrhythmia arising from the mitral annulus: a distinct subgroup of idiopathic ventricular arrhythmias. J Am Coll Cardiol 2005;45:877–886. - PubMed

5.3.4 Patient Safety

    1. Haines DE, Beheiry S, Akar JG, et al.Heart Rhythm Society expert consensus statement on electrophysiology laboratory standards: process, protocols, equipment, personnel, and safety. Heart Rhythm 2014; 11:e9–e51. - PMC - PubMed
    1. Miller MA, Dukkipati SR, Mittnacht AJ, et al.Activation and entrainment mapping of hemodynamically unstable ventricular tachycardia using a percutaneous left ventricular assist devices. J Am Coll Cardiol 2011; 58:1363–1371. - PubMed
    1. Lü F, Eckman PM, Liao KK, et al.Catheter ablation of hemodynamically unstable ventricular tachycardia with mechanical circulatory support. Int J Cardiol 2013;168:3859–3865. - PubMed
    1. Servatius H, Höfeler T, Hoffmann BA, et al.Propofol sedation administered by cardiologists for patients undergoing catheter ablation for ventricular tachycardia. Europace 2016;18:1245–1251. - PubMed
    1. American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology 2002; 96:1004–1017. - PubMed

5.4 Preprocedural Imaging

    1. Visser CA, Kan G, David GK, Lie KI, Durrer D. Two dimensional echocardiography in the diagnosis of left ventricular thrombus: a prospective study of 67 patients with anatomic validation. Chest 1983;83:228–232. - PubMed
    1. Ezekowitz MD, Wilson DA, Smith EO, et al.Comparison of Indium-111 platelet scintigraphy and two-dimensional echocardiography in the diagnosis of left ventricular thrombi. N Engl J Med 1982;306:1509–1513. - PubMed
    1. Stratton JR, Lighty GW Jr, Pearlman AS, Ritchie JL. Detection of left ventricular thrombus by two-dimensional echocardiography: sensitivity, specificity, and causes of uncertainty. Circulation 1982;66:156–166. - PubMed
    1. Thanigaraj S, Schechtman KB, Perez JE. Improved echocardiographic delineation of left ventricular thrombus with the use of intravenous second- generation contrast image enhancement. J Am Soc Echocardiogr 1999;12:1022–1026. - PubMed
    1. Weinsaft JW, Kim HW, Shah DJ, et al.Detection of left ventricular thrombus by delayed-enhancement cardiovascular magnetic resonance prevalence and markers in patients with systolic dysfunction. J Am Coll Cardiol 2008;52:148–157. - PubMed

5.5 Patient Preparation

    1. Douketis JD, Spyropoulos AC, Kaatz S, et al.; BRIDGE Investigators. Perioperative bridging anticoagulation in patients with atrial fibrillation. N Engl J Med 2015;373:823–833. - PMC - PubMed
    1. Smith I, Kranke P, Murat I, et al.Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol 2011;28:556–569. - PubMed
    1. American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology 2017;126:376–393. - PubMed

6.1 Anesthesia

    1. Wutzler A, Mueller A, Loehr L, et al.Minimal and deep sedation during ablation of ventricular tachycardia. Int J Cardiol 2014;172:161–164. - PubMed
    1. Servatius H, Höfeler T, Hoffmann BA, et al.Propofol sedation administered by cardiologists for patients undergoing catheter ablation for ventricular tachycardia. Europace 2016;18:1245–1251. - PubMed
    1. Nazer B, Woods C, Dewland T, Moyers B, Badhwar N, Gerstenfeld EP. Importance of ventricular tachycardia induction andmapping for patients referred for epicardial ablation. Pacing Clin Electrophysiol 2015;38:1333–1342. - PubMed
    1. American Society of Anesthesiologists Committee on Quality Management and Departmental Administration. Continuum of depth of sedation: definition of general anesthesia and levels of sedation/analgesia. Available at https://www.asahq.org/standards-and-guidelines/continuum-of-depth-ofseda.... Accessed October 12, 2018.
    1. Lü F, Lin J, Benditt DG. Conscious sedation and anesthesia in the cardiac electrophysiology laboratory. J Cardiovasc Electrophysiol 2013;24:237–245. - PubMed

6.2 Vascular Access

    1. Sharma PS, Padala SK, Gunda S, Koneru JN, Ellenbogen KA. Vascular complications during catheter ablation of cardiac arrhythmias: a comparison between vascular ultrasound guided access and conventional vascular access. J Cardiovasc Electrophysiol 2016;27:1160–1166. - PubMed
    1. Tanaka-Esposito CC, Chung MK, Abraham JM, Cantillon DJ, Abi-Saleh B, Tchou PJ. Real-time ultrasound guidance reduces total and major vascular complications in patients undergoing pulmonary vein antral isolation on therapeutic warfarin. J Interv Card Electrophysiol 2013;37:163–168. - PMC - PubMed
    1. Yamagata K, Wichterle D, Roubíček T, et al.Ultrasound-guided versus conventional femoral venipuncture for catheter ablation of atrial fibrillation: a multicentre randomized efficacy and safety trial (ULTRA-FAST trial). Europace 2018;20:1107–1114. - PubMed
    1. Sobolev M, Shiloh AL, Di Biase L, Slovut DP. Ultrasound-guided cannulation of the femoral vein in electrophysiological procedures: a systematic review and meta-analysis. Europace 2017;19:850–855. - PubMed
    1. Seto AH, Abu-Fadel MS, Sparling JM, et al.Real-time ultrasound guidance facilitates femoral arterial access and reduces vascular complications: FAUST (Femoral Arterial Access With Ultrasound Trial). JACC Cardiovasc Interv 2010;3:751–758. - PubMed

6.3.4 Epicardial Access Complications

    1. d’Avila A, Gutierrez P, Scanavacca M, et al.Effects of radiofrequency pulses delivered in the vicinity of the coronary arteries: implications for nonsurgical transthoracic epicardial catheter ablation to treat ventricular tachycardia. Pacing Clin Electrophysiol 2002;25:1488–1495. - PubMed
    1. Kawamura M, Kobayashi Y, Ito H, et al.Epicardial ablation with cooled tip catheter close to the coronary arteries is effective and safe in the porcine heart if the ventricular potential is being monitored in the epicardium and endocardium. Circ J 2006;70:926–932. - PubMed
    1. Viles-Gonzalez JF, de Castro Miranda R, Scanavacca M, Sosa E, d’Avila A. Acute and chronic effects of epicardial radiofrequency applications delivered on epicardial coronary arteries. Circ Arrhythm Electrophysiol 2011;4:526–531. - PubMed
    1. Sacher F, Roberts-Thomson K, Maury P, et al.Epicardial ventricular tachycardia ablation a multicenter safety study. J Am Coll Cardiol 2010; 55:2366–2372. - PubMed
    1. Roberts-Thomson KC, Seiler J, Steven D, et al.Percutaneous access of the epicardial space for mapping ventricular and supraventricular arrhythmias in patients with and without prior cardiac surgery. J Cardiovasc Electrophysiol 2010;21:406–411. - PubMed

6.4 Intraprocedural Hemodynamic Support

    1. Miller MA, Dukkipati SR, Mittnacht AJ, et al.Activation and entrainment mapping of hemodynamically unstable ventricular tachycardia using a percutaneous left ventricular assist device. J Am Coll Cardiol 2011;58:1363–1371. - PubMed
    1. Reddy YM, Chinitz L, Mansour M, et al.Percutaneous left ventricular assist devices in ventricular tachycardia ablation: multicenter experience. Circ Arrhythm Electrophysiol 2014;7:244–250. - PMC - PubMed
    1. Baratto F, Pappalardo F, Oloriz T, et al.Extracorporeal membrane oxygenation for hemodynamic support of ventricular tachycardia ablation. Circ Arrhythm Electrophysiol 2016;9:e004492. - PubMed
    1. Kusa S, Miller MA, Whang W, et al.Outcomes of ventricular tachycardia ablation using percutaneous left ventricular assist devices. Circ Arrhythm Electrophysiol 2017;10:e004717. - PubMed
    1. Mathuria N, Wu G, Rojas-Delgado F, et al.Outcomes of pre-emptive and rescue use of percutaneous left ventricular assist device in patients with structural heart disease undergoing catheter ablation of ventricular tachycardia. J Interv Card Electrophysiol 2017;48:27–34. - PubMed

6.5 Anticoagulation

    1. Reddy VY, Reynolds MR, Neuzil P, et al.Prophylactic catheter ablation for the prevention of defibrillator therapy. N Engl J Med 2007;357:2657–2665. - PMC - PubMed
    1. Kuck KH, Schaumann A, Eckardt L, et al.; VTACH Study Group. Catheter ablation of stable ventricular tachycardia before defibrillator implantation in patients with coronary heart disease (VTACH): a multicentre randomised controlled trial. Lancet 2010;375:31–40. - PubMed
    1. Al-Khatib SM, Daubert JP, Anstrom KJ, et al.Catheter ablation for ventricular tachycardia in patients with an implantable cardioverter defibrillator (CALYPSO) pilot trial. J Cardiovasc Electrophysiol 2015;26:151–157. - PubMed
    1. Sapp JL, Wells GA, Parkash R, et al.Ventricular tachycardia ablation versus escalation of antiarrhythmic drugs. N Engl J Med 2016;375:111–121. - PubMed
    1. KH, Tilz RR, Deneke Kuck T, et al.; SMS Investigators. Impact of substrate modification by catheter ablation on implantable cardioverter-defibrillator interventions in patients with unstable ventricular arrhythmias and coronary artery disease: results from the multicenter randomized controlled SMS (Substrate Modification Study). Circ Arrhythm Electrophysiol 2017; 10:e004422. - PubMed

6.6 Antibiotic Prophylaxis

    1. Wilson W, Taubert KA, Gewitz M, et al.Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007;116:1736–1754. - PubMed

7 Electrophysiological Testing

    1. Lerman BB, Belardinelli L, West GA, Berne RM, DiMarco JP. Adenosine-sensitive ventricular tachycardia: evidence suggesting cyclic AMP-triggered activity. Circulation 1986;74:270–280. - PubMed
    1. Lerman BB. Mechanism, diagnosis and treatment of outflow tract tachycardia. Nat Rev Cardiol 2015;12:597–608. - PubMed
    1. Buxton AE, Waxman HL, Marchlinski FE, Untereker WJ, Waspe LE, Josephson ME. Role of triple ventricular extrastimuli during electrophysiologic study of patients with documented sustained ventricular arrhythmias. Circulation 1984;69:532–540. - PubMed
    1. Hummel JD, Strickberger SA, Daoud E, et al.Results and efficiency of programmed ventricular stimulation with four extrastimuli compared with one, two and three extrastimuli. Circulation 1994;90:2827–2832. - PubMed
    1. Josephson ME. Clinical Cardiac Electrophysiology: Techniques and Interpretations, 5th ed.Philadelphia: Wolters Kluwer; 2015, Chapter 11, p. 479.

8.1.1. Multielectrode Mapping

    1. Tschabrunn CM, Roujol S, Dorman NC, Nezafat R, Josephson ME, Anter E. High-resolution mapping of ventricular scar: comparison between single and multielectrode catheters. Circ Arrhythm Electrophysiol 2016;9:e003841. - PMC - PubMed
    1. Leshem E, Tschabrunn CM, Jang J, et al.High-resolution mapping of ventricular scar: evaluation of a novel integrated multielectrode mapping and ablation catheter. JACC Clin Electrophysiol 2017;3:220–231. - PubMed
    1. Berte B, Relan J, Sacher F, et al.Impact of electrode type on mapping of scar-related VT. J Cardiovasc Electrophysiol 2015;26:1213–1223. - PubMed
    1. Anter E, Tschabrunn CM, Josephson ME. High-resolution mapping of scar-related atrial arrhythmias using smaller electrodes with closer interelectrode spacing. Circ Arrhythm Electrophysiol 2015;8:537–545. - PubMed
    1. Anter E, Tschabrunn CM, Buxton AE, Josephson ME. High-resolution mapping of postinfarction reentrant ventricular tachycardia: electrophysiological characterization of the circuit. Circulation 2016;134:314–327. - PMC - PubMed

8.2 Activation Mapping

    1. Josephson ME. Recurrent ventricular tachycardia, Clinical Cardiac Electrophysiology: Techniques and Interpretations, 5th ed. Philadelphia: Wolters Kluwer; 2015.
    1. Josephson ME, Anter E. Substrate mapping for ventricular tachycardia: assumptions and misconceptions. JACC Clin Electrophysiol 2015; 1:341–352. - PubMed
    1. Miller JM, Harken AH, Hargrove WC, Josephson ME. Pattern of endocardial activation during sustained ventricular tachycardia. J Am Coll Cardiol 1985; 6:1280–1287. - PubMed
    1. Anter E, Tschabrunn CM, Buxton AE, Josephson ME. High-resolution mapping of postinfarction reentrant ventricular tachycardia: electrophysiological characterization of the circuit. Circulation 2016;134:314–327. - PMC - PubMed
    1. Miller MA, Dukkipati SR, Mittnacht AJ, et al.Activation and entrainment mapping of hemodynamically unstable ventricular tachycardia using a percutaneous left ventricular assist device. J Am Coll Cardiol 2011;58:1363–1371. - PubMed

8.3.2 How to Perform Entrainment Mapping

    1. Stevenson WG, Friedman PL, Sager PT, et al.Exploring postinfarction reentrant ventricular tachycardia with entrainment mapping. J Am Coll Cardiol 1997;29:1180–1189. - PubMed
    1. Kadish AH, Childs K, Schmaltz S, Morady F. Differences in QRS configuration during unipolar pacing from adjacent sites: implications for the spatial resolution of pace-mapping. J Am Coll Cardiol 1991; 17:143–151. - PubMed
    1. Kalbfleisch SJ, Sousa J, el-Atassi R, Calkins H, Langberg J, Morady F. Repolarization abnormalities after catheter ablation of accessory atrioventricular connections with radiofrequency current. J Am Coll Cardiol 1991; 18:1761–1766. - PubMed
    1. Morady F, Kadish A, Rosenheck S, et al.Concealed entrainment as a guide for catheter ablation of ventricular tachycardia in patients with prior myocardial infarction. J Am Coll Cardiol 1991;17:678–689. - PubMed
    1. Fontaine G, Frank R, Tonet J, Grosgogeat Y. Identification of a zone of slow conduction appropriate for VT ablation: theoretical and practical considerations. Pacing Clin Electrophysiol 1989;12:262–267. - PubMed

8.4 Pace Mapping

    1. Gerstenfeld EP, Dixit S, Callans DJ, Rajawat Y, Rho R, Marchlinski FE. Quantitative comparison of spontaneous and paced 12-lead electrocardiogram during right ventricular outflow tract ventricular tachycardia. J Am Coll Cardiol 2003;41:2046–2053. - PubMed
    1. Kurosaki K, Nogami A, Sakamaki M, et al.Automated template matching to pinpoint the origin of right ventricular outflow tract tachycardia. Pacing Clin Electrophysiol 2009;32:S47–S51. - PubMed
    1. De Chillou C, Groben L, Magnin-Poull I, et al.Localizing the critical isthmus of postinfarct ventricular tachycardia: the value of pace-mapping during sinus rhythm. Heart Rhythm 2014;11:175–181. - PubMed
    1. Calkins H, Kalbfleisch SJ, El-atassi R, Langberg JJ, Morady F. Relation between efficacy of radiofrequency catheter ablation and site of origin of idiopathic ventricular tachycardia. Am J Cardiol 1993;71:827–833. - PubMed
    1. Bogun F, Taj M, Ting M, et al.Spatial resolution of pace mapping of idiopathic ventricular tachycardia/ectopy originating in the right ventricular outflow tract. Heart Rhythm 2008;5:339–344. - PubMed

8.5.2. Summary

    1. Reddy VY, Reynolds MR, Neuzil P, et al.Prophylactic catheter ablation for the prevention of defibrillator therapy. N Engl J Med 2007; 357:2657–2665. - PMC - PubMed
    1. Di Biase L, Burkhardt JD, Lakkireddy D, et al.Ablation of stable VTs versus substrate ablation in ischemic cardiomyopathy: the VISTA randomized multicenter trial. J Am Coll Cardiol 2015;66:2872–2882. - PubMed
    1. Calkins H, Epstein A, Packer D, et al.Catheter ablation of ventricular tachycardia in patients with structural heart disease using cooled radiofrequency energy: results of a prospective multicenter study. Cooled RF Multi Center Investigators Group. J Am Coll Cardiol 2000;35:1905–1914. - PubMed
    1. Stevenson WG, Wilber DJ, Natale A, et al.Irrigated radiofrequency catheter ablation guided by electroanatomic mapping for recurrent ventricular tachycardia after myocardial infarction: the multicenter thermocool ventricular tachycardia ablation trial. Circulation 2008;118:2773–2782. - PubMed
    1. Sapp JL, Wells GA, Parkash R, et al.Ventricular tachycardia ablation versus escalation of antiarrhythmic drugs. N Engl J Med 2016; 375:111–121. - PubMed

8.6.2. Summary

    1. Ouyang F, Fotuhi P, Ho SY, et al.Repetitivemonomorphic ventricular tachycardia originating fromthe aortic sinus cusp: electrocardiographic characterization for guiding catheter ablation. J Am Coll Cardiol 2002;39:500–508. - PubMed
    1. Hoffmayer KS, Dewland TA, Hsia HH, et al.Safety of radiofrequency catheter ablation without coronary angiography in aortic cusp ventricular arrhythmias. Heart Rhythm 2014;11:1117–1121. - PubMed
    1. Hachiya H, Aonuma K, Yamauchi Y, Igawa M, Nogami A, Iesaka Y. How to diagnose, locate, and ablate coronary cusp ventricular tachycardia. J Cardiovasc Electrophysiol 2002;13:551–556. - PubMed
    1. Yamada T, McElderry HT, Doppalapudi H, et al.Idiopathic ventricular arrhythmias originating from the aortic root prevalence, electrocardiographic and electrophysiologic characteristics, and results of radiofrequency catheter ablation. J Am Coll Cardiol 2008;52:139–147. - PubMed
    1. Baman TS, Ilg KJ, Gupta SK, et al.Mapping and ablation of epicardial idiopathic ventricular arrhythmias from within the coronary venous system. Circ Arrhythm Electrophysiol 2010;3:274–279. - PubMed

8.7 Electroanatomic Mapping Systems and Robotic Navigation

    1. Khaykin Y, Skanes A, Whaley B, et al.Real-time integration of 2D intracardiac echocardiography and 3D electroanatomical mapping to guide ventricular tachycardia ablation. Heart Rhythm 2008;5:1396–1402. - PubMed
    1. Sporton SC, Earley MJ, Nathan AW, Schilling RJ. Electroanatomic versus fluoroscopic mapping for catheter ablation procedures: a prospective randomized study. J Cardiovasc Electrophysiol 2004;15:310–315. - PubMed
    1. Earley MJ, Showkathali R, Alzetani M, et al.Radiofrequency ablation of arrhythmias guided by non-fluoroscopic catheter location: a prospective randomized trial. Eur Heart J 2006;27:1223–1229. - PubMed
    1. Marchlinski FE, Callans DJ, Gottlieb CD, Zado E. Linear ablation lesions for control of unmappable ventricular tachycardia in patients with ischemic and nonischemic cardiomyopathy. Circulation 2000;101:1288–1296. - PubMed
    1. Khongphatthanayothin A, Kosar E, Nademanee K. Nonfluoroscopic threedimensional mapping for arrhythmia ablation: tool or toy? J Cardiovasc Electrophysiol 2000;11:239–243. - PubMed

9.1.9 Stereotactic Radiotherapy

    1. Tokuda M, Kojodjojo P, Tung S, et al.Characteristics of clinical and induced ventricular tachycardia throughout multiple ablation procedures. J Cardiovasc Electrophysiol 2016;27:88–94. - PubMed
    1. Kumar S, Barbhaiya CR, Sobieszczyk P, et al.Role of alternative interventional procedures when endo- and epicardial catheter ablation attempts for ventricular arrhythmias fail. Circ Arrhythm Electrophysiol 2015; 8:606–615. - PubMed
    1. Soejima K, Couper G, Cooper JM, Sapp JL, Epstein LM, Stevenson WG. Subxiphoid surgical approach for epicardial catheter-based mapping and ablation in patients with prior cardiac surgery or difficult pericardial access. Circulation 2004;110:1197–1201. - PubMed
    1. Tokuda M, Kojodjojo P, Tung S, et al.Acute failure of catheter ablation for ventricular tachycardia due to structural heart disease: causes and significance. J Am Heart Assoc 2013;2:e000072. - PMC - PubMed
    1. Dinov B, Fiedler L, Schonbauer R, et al.Outcomes in catheter ablation of ventricular tachycardia in dilated nonischemic cardiomyopathy compared with ischemic cardiomyopathy: results from the Prospective Heart Centre of Leipzig VT (HELP-VT) Study. Circulation 2014;129:728–736. - PubMed

9.2.7 Deep Intraseptal Sites

    1. Maury P, Rollin A, Mondoly P, Duparc A. Management of outflow tract ventricular arrhythmias. Curr Opin Cardiol 2015;30:50–57. - PubMed
    1. Bala R, Marchlinski FE. Electrocardiographic recognition and ablation of outflow tract ventricular tachycardia. Heart Rhythm 2007;4:366–370. - PubMed
    1. Wang C, Zhang Y, Hong F, Huang Y. Pulmonary artery: a pivotal site for catheter ablation in idiopathic RVOT ventricular arrhythmias. Pacing Clin Electrophysiol 2017;40:803–807. - PubMed
    1. Hutchinson MD, Garcia FC. An organized approach to the localization, mapping, and ablation of outflow tract ventricular arrhythmias. J Cardiovasc Electrophysiol 2013;24:1189–1197. - PubMed
    1. Asirvatham SJ. Correlative anatomy for the invasive electrophysiologist: outflow tract and supravalvar arrhythmia. J Cardiovasc Electrophysiol 2009;20:955–968. - PubMed

9.3.1 Ventricular Arrhythmias from the Tricuspid and Mitral Annuli

    1. Wasmer K, Köbe J, Dechering DG, et al.Ventricular arrhythmias from the mitral annulus: patient characteristics, electrophysiological findings, ablation, and prognosis. Heart Rhythm 2013;10:783–788. - PubMed
    1. Kumagai K, Yamauchi Y, Takahashi A, et al.Idiopathic left ventricular tachycardia originating from the mitral annulus. J Cardiovasc Electrophysiol 2005;16:1029–1036. - PubMed
    1. Tada H, Ito S, Naito S, et al.Idiopathic ventricular arrhythmia arising from the mitral annulus: a distinct subgroup of idiopathic ventricular arrhythmias. J Am Coll Cardiol 2005;45:877–886. - PubMed
    1. Al’Aref SJ, Ip JE, Markowitz SM, et al.Differentiation of papillary muscle from fascicular and mitral annular ventricular arrhythmias in patients with and without structural heart disease. Circ Arrhythm Electrophysiol 2015; 8:616–624. - PubMed
    1. Yue-Chun L, Wen-Wu Z, Na-Dan Z, et al.Idiopathic premature ventricular contractions and ventricular tachycardias originating from the vicinity of tricuspid annulus: results of radiofrequency catheter ablation in thirty-five patients. BMC Cardiovasc Disord 2012;12:32. - PMC - PubMed

9.3.2 Mapping and Ablation of Ventricular Arrhythmia from the Papillary Muscles

    1. Latchamsetty RY, Yokokawa M, Morady F, et al.Multicenter outcomes for catheter ablation of idiopathic premature ventricular complexes. JACC Clin Electrophysiol 2015;1:116–123. - PubMed
    1. Abouezzeddine O, Suleiman M, Buescher T, et al.Relevance of endocavitary structures in ablation procedures for ventricular tachycardia. J Cardiovasc Electrophysiol 2010;21:245–254. - PubMed
    1. Doppalapudi H, Yamada T, McElderry HT, Plumb VJ, Epstein AE, Kay GN. Ventricular tachycardia originating from the posterior papillary muscle in the left ventricle: a distinct clinical syndrome. Circ Arrhythm Electrophysiol 2008;1:23–29. - PubMed
    1. Enriquez A, Supple GE, Marchlinski FE, Garcia FC. How to map and ablate papillary muscle ventricular arrhythmias. Heart Rhythm 2017; 14:1721–1728. - PubMed
    1. Bogun F, Desjardins B, Crawford T, et al.Post-infarction ventricular arrhythmias originating in papillary muscles. J Am Coll Cardiol 2008; 51:1794–1802. - PubMed

9.4.2.4 Outcomes and Risks

    1. Guerot C, Valere PE, Castillo-Fenoy A, Tricot R. [Tachycardia by branch-to-branch reentry]. Arch Mal Coeur Vaiss 1974;67:1–11. - PubMed
    1. Akhtar M, Damato AN, Batsford WP, Ruskin JN, Ogunkelu JB, Vargas G. Demonstration of re-entry within the His-Purkinje system in man. Circulation 1974;50:1150–1162. - PubMed
    1. Blanck Z, Dhala A, Deshpande S, Sra J, Jazayeri M, Akhtar M. Bundle branch reentrant ventricular tachycardia: cumulative experience in 48 patients. J Cardiovasc Electrophysiol 1993;4:253–262. - PubMed
    1. Lloyd EA, Zipes DP, Heger JJ, Prystowsky EN Sustained ventricular tachycardia due to bundle branch reentry. Am Heart J 1982; 104:1095–1097. - PubMed
    1. Touboul P, Kirkorian G, Atallah G, Moleur P. Bundle branch reentry: a possible mechanism of ventricular tachycardia. Circulation 1983; 67:674–680. - PubMed

9.4.4.3 Outcomes and Risks

    1. Zipes DP, Foster PR, Troup PJ, Pedersen DH. Atrial induction of ventricular tachycardia: reentry versus triggered automaticity. Am J Cardiol 1979;44:1–8. - PubMed
    1. Belhassen B, Rotmensch HH, Laniado S. Response of recurrent sustained ventricular tachycardia to verapamil. Br Heart J 1981;46:679–682. - PMC - PubMed
    1. Ohe T, Shimomura K, Aihara N, et al.Idiopathic sustained left ventricular tachycardia: clinical and electrophysiologic characteristics. Circulation 1988;77:560–568. - PubMed
    1. Nogami A. Idiopathic left ventricular tachycardia: assessment and treatment. Card Electrophysiol Rev 2002;6:448–457. - PubMed
    1. Talib AK, Nogami A, Nishiuchi S, et al.Verapamil-sensitive upper septal idiopathic left ventricular tachycardia: prevalence, mechanism, and electrophysiological characteristics. JACC Clin Electrophysiol 2015;1:369–380. - PubMed

9.5.5 Epicardial Mapping and Ablation

    1. de Bakker JM, Coronel R, Tasseron S, et al.Ventricular tachycardia in the infarcted, Langendorff-perfused human heart: role of the arrangement of surviving cardiac fibers. J Am Coll Cardiol 1990;15:1594–1607. - PubMed
    1. de Bakker JM, van Capelle FJ, Janse MJ, et al.Macroreentry in the infarcted human heart: the mechanism of ventricular tachycardias with a “focal” activation pattern. J Am Coll Cardiol 1991;18:1005–1014. - PubMed
    1. Kaltenbrunner W, Cardinal R, Dubuc M, et al.Epicardial and endocardial mapping of ventricular tachycardia in patients with myocardial infarction. Is the origin of the tachycardia always subendocardially localized? Circulation 1991;84:1058–1071. - PubMed
    1. Downar E, Harris L, Mickleborough LL, Shaikh N, Parson ID. Endocardial mapping of ventricular tachycardia in the intact human ventricle: evidence for reentrant mechanisms. J Am Coll Cardiol 1988;11:783–791. - PubMed
    1. Das MK, Scott LR, Miller JM. Focal mechanism of ventricular tachycardia in coronary artery disease. Heart Rhythm 2010;7:305–311. - PubMed

9.6 Dilated Cardiomyopathy

    1. McNally EM, Mestroni L. Dilated cardiomyopathy: genetic determinants and mechanisms. Circ Res 2017;121:731–748. - PMC - PubMed
    1. Ellenbogen KA, Levine JH, Berger RD, et al.; Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators. Are implantable cardioverter defibrillator shocks a surrogate for sudden cardiac death in patients with nonischemic cardiomyopathy? Circulation 2006; 113:776–782. - PubMed
    1. Kober L, Thune JJ, Nielsen JC, et al.Defibrillator implantation in patients with nonischemic systolic heart failure. N Engl J Med 2016; 375:1221–1230. - PubMed
    1. Gatzoulis KA, Vouliotis AI, Tsiachris D, et al.Primary prevention of sudden cardiac death in a nonischemic dilated cardiomyopathy population: reappraisal of the role of programmed ventricular stimulation. Circ Arrhythm Electrophysiol 2013;6:504–512. - PubMed
    1. Aldhoon B, Tzou WS, Riley MP, et al.Nonischemic cardiomyopathy substrate and ventricular tachycardia in the setting of coronary artery disease. Heart Rhythm 2013;10:1622–1627. - PubMed

9.7 Ventricular Tachycardia Ablation in Hypertrophic Cardiomyopathy

    1. Maron BJ, Anan TJ, Roberts WC. Quantitative analysis of the distribution of cardiac muscle cell disorganization in the left ventricular wall of patients with hypertrophic cardiomyopathy. Circulation 1981;63:882–894. - PubMed
    1. Maron BJ. Contemporary insights and strategies for risk stratification and prevention of sudden death in hypertrophic cardiomyopathy. Circulation 2010;121:445–456. - PubMed
    1. Basso C, Thiene G, Corrado D, Buja G, Melacini P, Nava A. Hypertrophic cardiomyopathy and sudden death in the young: pathologic evidence of myocardial ischemia. Hum Pathol 2000;31:988–998. - PubMed
    1. Almaas VM, Haugaa KH, Strom EH, et al.Increased amount of interstitial fibrosis predicts ventricular arrhythmias, and is associated with reduced myocardial septal function in patients with obstructive hypertrophic cardiomyopathy. Europace 2013;15:1319–1327. - PubMed
    1. Rudolph A, Abdel-Aty H, Bohl S, et al.Noninvasive detection of fibrosis applying contrast-enhanced cardiac magnetic resonance in different forms of left ventricular hypertrophy relation to remodeling. J Am Coll Cardiol 2009;53:284–291. - PubMed

9.8.6 Risks

    1. Haissaguerre M, Extramiana F, Hocini M, et al.Mapping and ablation of ventricular fibrillation associated with long-QT and Brugada syndromes. Circulation 2003;108:925–928. - PubMed
    1. Nademanee K, Hocini M, Haissaguerre M. Epicardial substrate ablation for Brugada syndrome. Heart Rhythm 2017;14:457–461. - PubMed
    1. Andorin A, Gourraud JB, Mansourati J, et al.The QUIDAMstudy: hydroquinidine therapy for the management of Brugada syndrome patients at high arrhythmic risk. Heart Rhythm 2017;14:1147–1154. - PubMed
    1. Vutthikraivit W, Rattanawong P, Putthapiban P, et al.Worldwide prevalence of Brugada syndrome: a systematic review and meta-analysis. Acta Cardiol Sin 2018;34:267–277. - PMC - PubMed
    1. Brugada P, Brugada J. Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report. J Am Coll Cardiol 1992; 20:1391–1396. - PubMed

9.9 Polymorphic Ventricular Tachycardia/Ventricular Fibrillation Triggers

    1. Haïssaguerre M, Shoda M, Jaïs P, et al.Mapping and ablation of idiopathic ventricular fibrillation. Circulation 2002;106:962–967. - PubMed
    1. Haïssaguerre M, Shah DC, Jaïs P, et al.Role of Purkinje conducting system in triggering of idiopathic ventricular fibrillation. Lancet 2002;359:677–678. - PubMed
    1. Haïssaguerre M, Extraminiana F, Hocini M, et al.Mapping and ablation of ventricular fibrillation associated with long-QT and Brugada syndromes. Circulation 2003;108:925–928. - PubMed
    1. Bansch D, Ouyang F, Antz M, et al.Successful catheter ablation of electrical storm after myocardial infarction. Circulation 2003;108:3011–3016. - PubMed
    1. Marrouche NF, Verma A, Wazni O, et al.Mode of initiation and ablation of ventricular fibrillation storms in patients with ischemic cardiomyopathy. J Am Coll Cardiol 2004;43:1715–1720. - PubMed

9.10.4 Risks

    1. Basso C, Corrado D, Markus FI, Nava A, Thiene G. Arrhythmogenic right ventricular cardiomyopathy. Lancet 2009;373:1289–1300. - PubMed
    1. Boulos M, Lashevsky I, Reisner S, Gepstein L. Electroanatomic mapping of arrhythmogenic right ventricular dysplasia. J Am Coll Cardiol 2001; 38:2020–2027. - PubMed
    1. Te Riele AS, James CA, Philips B, et al.Mutation-positive arrhythmogenic right ventricular dysplasia/cardiomyopathy: the triangle of dysplasia displaced. J Cardiovasc Electrophysiol 2013; 24:1311–1320. - PMC - PubMed
    1. Fernández-Armenta J, Andreu D, Penela D, et al.Sinus rhythm detection of conducting channels and ventricular tachycardia isthmus in arrhythmogenic right ventricular cardiomyopathy. Heart Rhythm 2014; 11:747–754. - PubMed
    1. Berruezo A, Acosta J, Fernández-Armenta J, et al.Safety, long-term outcomes and predictors of recurrence after first-line combined endoepicardial ventricular tachycardia substrate ablation in arrhythmogenic cardiomyopathy. Impact of arrhythmic substrate distribution pattern. A prospective multicentre study. Europace 2017;19:607–616. - PubMed

9.11.3 Outcome After Ablation

    1. Gonska BD, Cao K, Raab J, Eigster G, Kreuzer H. Radiofrequency catheter ablation of right ventricular tachycardia late after repair of congenital heart defects. Circulation 1996;94:1902–1908. - PubMed
    1. Zeppenfeld K, Schalij MJ, Bartelings MM, et al.Catheter ablation of ventricular tachycardia after repair of congenital heart disease: electroanatomic identification of the critical right ventricular isthmus. Circulation 2007;116:2241–2252. - PubMed
    1. Kriebel T, Saul JP, Schneider H, Sigler M, Paul T. Noncontact mapping and radiofrequency catheter ablation of fast and hemodynamically unstable ventricular tachycardia after surgical repair of tetralogy of Fallot. J Am Coll Cardiol 2007;50:2162–2168. - PubMed
    1. Kapel GF, Reichlin T, Wijnmaalen AP, et al.Re-entry using anatomically determined isthmuses: a curable ventricular tachycardia in repaired congenital heart disease. Circ Arrhythm Electrophysiol 2015; 8:102–109. - PubMed
    1. Morwood JG, Triedman JK, Berul CI, et al.Radiofrequency catheter ablation of ventricular tachycardia in children and young adults with congenital heart disease. Heart Rhythm 2004;1:301–308. - PubMed

9.12 Sarcoidosis

    1. Okura Y, Dec GW, Hare JM, et al.A clinical and histopathologic comparison of cardiac sarcoidosis and idiopathic giant cell myocarditis. J Am Coll Cardiol 2003;41:322–329. - PubMed
    1. Litovsky SH, Burke AP, Virmani R. Giant cell myocarditis: an entity distinct from sarcoidosis characterized by multiphasic myocyte destruction by cytotoxic T cells and histiocytic giant cells. Mod Pathol 1996; 9:1126–1134. - PubMed
    1. Trachtenberg BH, Hare JM. Inflammatory cardiomyopathic syndromes. Circ Res 2017;121:803–818. - PubMed
    1. Birnie DH, Sauer WH, Bogun F, et al.HRS expert consensus statement on the diagnosis and management of arrhythmias associated with cardiac sarcoidosis. Heart Rhythm 2014;11:1305–1323. - PubMed
    1. Kandolin R, Lehtonen J, Airaksinen J, et al.Cardiac sarcoidosis: epidemiology, characteristics, and outcome over 25 years in a nationwide study. Circulation 2015;131:624–632. - PubMed

9.13.3. Epicardial Ablation of Sustained Ventricular Tachycardia in Chagas Heart Disease

    1. Bocchi EA, Bestetti RB, Scanavacca MI, Cunha Neto E, Issa VS. Chronic Chagas heart disease management: from etiology to cardiomyopathy treatment. J Am Coll Cardiol 2017;70:1510–1524. - PubMed
    1. Healy C, Viles-Gonzalez JF, Sáenz LC, Soto M, Ramírez JD, d’Avila A. Arrhythmias in Chagasic cardiomyopathy. Card Electrophysiol Clin 2015; 7:251–268. - PubMed
    1. Sosa E, Scanavacca M, d’Avila A, et al.Endocardial and epicardial ablation guided by nonsurgical transthoracic epicardial mapping to treat recurrent ventricular tachycardia. J Cardiovasc Electrophysiol 1998;9:229–239. - PubMed
    1. Scanavacca M, Sosa E Epicardial ablation of ventricular tachycardia in Chagas heart disease. Card Electrophysiol Clin 2010;2:55–67. - PubMed
    1. Scanavacca M, Sosa E, d’Avila A, De Lourdes Higuchi M. Radiofrequency ablation of sustained ventricular tachycardia related to the mitral isthmus in Chagas’ disease. Pacing Clin Electrophysiol 2002;25:368–371. - PubMed

9.14.4 Left Ventricular Assist Devices

    1. Hasselberg NE, Haland TF, Saberniak J, et al.Lamin A/C cardiomyopathy: young onset, high penetrance, and frequent need for heart transplantation. Eur Heart J 2018;39:853–860. - PMC - PubMed
    1. van Berlo JH, de Voogt WG, van der Kooi AJ, et al.Meta-analysis of clinical characteristics of 299 carriers of LMNA gene mutations: do lamin A/C mutations portend a high risk of sudden death? J Mol Med (Berl) 2005;83:79–83. - PubMed
    1. van Berlo JH, Duboc D, Pinto YM. Often seen but rarely recognised: cardiac complications of lamin A/C mutations. Eur Heart J 2004; 25:812–814. - PubMed
    1. Kumar S, Baldinger SH, Gandjbakhch E, et al.Long-term arrhythmic and nonarrhythmic outcomes of Lamin A/C mutation carriers. J Am Coll Cardiol 2016;68:2299–2307. - PubMed
    1. Hasselberg NE, Edvardsen T, Petri H, et al.Risk prediction of ventricular arrhythmias and myocardial function in Lamin A/C mutation positive subjects. Europace 2014;16:563–571. - PubMed

9.15 Surgical Therapy

    1. Tokuda M, Kojodjojo P, Tung S, et al.Acute failure of catheter ablation for ventricular tachycardia due to structural heart disease: causes and significance. J Am Heart Assoc 2013;2:e000072. - PMC - PubMed
    1. Roberts-Thomson KC, Seiler J, Steven D, et al.Percutaneous access of the epicardial space for mapping ventricular and supraventricular arrhythmias in patients with and without prior cardiac surgery. J Cardiovasc Electrophysiol 2010;21:406–411. - PubMed
    1. Kumar S, Barbhaiya CR, Sobieszczyk P, et al.Role of alternative interventional procedures when endo- and epicardial catheter ablation attempts for ventricular arrhythmias fail. Circ Arrhythm Electrophysiol 2015; 8:606–615. - PubMed
    1. Soejima K, Couper G, Cooper JM, Sapp JL, Epstein LM, Stevenson WG. Subxiphoid surgical approach for epicardial catheter-based mapping and ablation in patients with prior cardiac surgery or difficult pericardial access. Circulation 2004;110:1197–1201. - PubMed
    1. Anter E, Hutchinson MD, Deo R, et al.Surgical ablation of refractory ventricular tachycardia in patients with nonischemic cardiomyopathy. Circ Arrhythm Electrophysiol 2011;4:494–500. - PubMed

9.16 Sympathetic Modulation

    1. Krul SPJ, Berger WR, Veldkamp MW, et al.Treatment of atrial and ventricular arrhythmias through autonomic modulation. JACC Clin Electrophysiol 2015;1:496–508. - PubMed
    1. Matsunari I, Aoki H, Nomura Y, et al.Iodine-123 metaiodobenzylguanidine imaging and carbon-11 hydroxyephedrine positron emission tomography compared in patients with left ventricular dysfunction. Circ Cardiovasc Imaging 2010;3:595–603. - PubMed
    1. Krittayaphong R, Bhuripanyo K, Punlee K, Kangkagate C, Chaithiraphan S. Effect of atenolol on symptomatic ventricular arrhythmia without structural heart disease: a randomized placebo-controlled study. Am Heart J 2002;144:e10. - PubMed
    1. Schwartz PJ, Motolese M, Pollavini G, et al.; Italian Sudden Death Prevention Group. Prevention of sudden cardiac death after a first myocardial infarction by pharmacologic or surgical antiadrenergic interventions. J Cardiovasc Electrophysiol 1992;3:2–16.
    1. Nademanee K, Taylor R, Bailey WE, Rieders DE, Kosar EM. Treating electrical storm: sympathetic blockade versus advanced cardiac life support- guided therapy. Circulation 2000;102:742–747. - PubMed

9.17.4 Summary

    1. Horowitz LN, Josephson ME, Farshidi A, Spielman SR, Michelson EL, Greenspan AM. Recurrent sustained ventricular tachycardia 3. Role of the electrophysiologic study in selection of antiarrhythmic regimens. Circulation 1978;58:986–997. - PubMed
    1. Miller JM, Kienzle MG, Harken AH, Josephson ME. Subendocardial resection for ventricular tachycardia: predictors of surgical success. Circulation 1984;70:624–631. - PubMed
    1. Kudenchuk PJ, Kron J, Walance CG, Cutler JE, Griffith KK, McAnulty JH. Day-to-day reproducibility of antiarrhythmic drug trials using programmed extrastimulus techniques for ventricular tachyarrhythmias associated with coronary artery disease. Am J Cardiol 1990; 66:725–730. - PubMed
    1. de Riva M, Piers SRD, Kapel GFL, et al.Reassessing noninducibility as ablation endpoint of post-infarction ventricular tachycardia: the impact of left ventricular function. Circ Arrhythm Electrophysiol 2015;8:853–862. - PubMed
    1. Ghanbar H, Baser K, Yokokawa M, et al.Noninducibility in postinfarction ventricular tachycardia as an end point for ventricular tachycardia ablation and its effects on outcomes: a meta-analysis. Circ Arrhythm Electrophysiol 2014;7:677–683. - PubMed

10 Postprocedural Care

    1. Jackson N, McGee M, Ahmed W, et al.Groin haemostasis with a purse string suture for patients following catheter ablation procedures (GITAR study). Heart Lung Circ 2018 March 20; 10.1016/j.hlc.2018.03.011 [Epub ahead of print]. - DOI - PubMed
    1. Pracon R, Bangalore S, Henzel J, et al.A randomized comparison of modified subcutaneous “Z”-stitch versus manual compression to achieve hemostasis after large caliber femoral venous sheath removal. Catheter Cardiovasc Interv 2018;91:105–112. - PubMed
    1. Ben-Dor I, Craig P, Torguson R, et al.MynxGrip vascular closure device versus manual compression for hemostasis of percutaneous transfemoral venous access closure: results from a prospective multicenter randomized study. Cardiovasc Revasc Med 2018;19:418–422. - PubMed
    1. Aytemir K, Canpolat U, Yorgun H, et al.Usefulness of ‘figure-of-eight’ suture to achieve haemostasis after removal of 15-French calibre femoral venous sheath in patients undergoing cryoablation. Europace 2016;18:1545–1550. - PubMed
    1. Lakshmanadoss U, Wong WS, Kutinsky I, Khalid MR, Williamson B, Haines DE. Figure-of-eight suture for venous hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation. Indian Pacing Electrophysiol J 2017;17:134–139. - PMC - PubMed

10.1.4 Postprocedural Care: Disposition

    1. Stevenson WG, Wilber DJ, Natale A, et al.Irrigated radiofrequency catheter ablation guided by electroanatomic mapping for recurrent ventricular tachycardia after myocardial infarction: the multicenter Thermocool ventricular tachycardia ablation trial. Circulation 2008;118:2773–2782. - PubMed
    1. Siontis KC, Jame S, Sharaf Dabbagh G, et al.Thromboembolic prophylaxis protocol with warfarin after radiofrequency catheter ablation of infarct-related ventricular tachycardia. J Cardiovasc Electrophysiol 2018;29:584–590. - PubMed
    1. Patel AA, Clyne CA, Henyan NN, et al.The use of protamine after radiofrequency catheter ablation: a pilot study. J Interv Card Electrophysiol 2007;18:155–158. - PubMed
    1. Ghannam M, Chugh A, Dillon P, et al.Protamine to expedite vascular hemostasis after catheter ablation of atrial fibrillation: a randomized controlled trial. Heart Rhythm 2018;15:1642–1647. - PubMed
    1. Calkins H, Epstein A, Packer D, et al.; Cooled RF Multi Center Investigators Group. Catheter ablation of ventricular tachycardia in patients with structural heart disease using cooled radiofrequency energy: results of a prospective multicenter study. J Am Coll Cardiol 2000; 35:1905–1914. - PubMed

10.2.9 Atrioventricular Block

    1. Palaniswamy C, Kolte D, Harikrishnan P, et al.Catheter ablation of postinfarction ventricular tachycardia: ten-year trends in utilization, in-hospital complications, and in-hospital mortality in the United States. Heart Rhythm 2014;11:2056–2063. - PubMed
    1. Katz DF, Turakhia MP, Sauer WH, et al.Safety of ventricular tachycardia ablation in clinical practice: findings from 9699 hospital discharge records. Circ. Arrhythmia Electrophysiol 2015;8:362–370. - PMC - PubMed
    1. Latchamsetty R, Yokokawa M, Morady F, et al.Multicenter outcomes for catheter ablation of idiopathic premature ventricular complexes. JACC Clin Electrophysiol 2015;1:116–123. - PubMed
    1. Pothineni NV, Deshmukh A, Padmanabhan D, et al.Complication rates of ventricular tachycardia ablation: comparison of safety outcomes derived from administrative databases and clinical trials. Int J Cardiol 2015;201:529–531. - PubMed
    1. Peichl P, Wichterle D, Pavlu L, Cihak R, Aldhoon B, Kautzner J. Complications of catheter ablation of ventricular tachycardia: a single center experience. Circ Arrhythm Electrophysiol 2014;7:684–690. - PubMed

10.3 Hemodynamic Deterioration and Proarrhythmia

    1. Cheitlin MD, Alpert JS, Armstrong WF, et al.ACC/AHA guidelines for the clinical application of echocardiography: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography). Circulation 1997;95:1686–1744. - PubMed
    1. Stevenson WG, Friedman PL, Kocovic D, Sager PT, Saxon LA, Pavri B. Radiofrequency catheter ablation of ventricular tachycardia after myocardial infarction. Circulation 1998;98:308–314. - PubMed
    1. Stevenson WG, Wilber DJ, Natale A, et al.; Multicenter Thermocool VT Ablation Trial Investigators. Irrigated radiofrequency catheter ablation guided by electroanatomic mapping for recurrent ventricular tachycardia after myocardial infarction: the multicenter thermocool ventricular tachycardia ablation trial. Circulation 2008;118:2773–2782. - PubMed
    1. Segal OR, Chow AW, Markides V, Schilling RJ, Peters NS, Davies W. Long-term results after ablation of infarct-related ventricular tachycardia. Heart Rhythm 2005;2:474–482. - PubMed
    1. Calkins H, Epstein A, Packer D, et al.; Cooled RF Multi Center Investigators Group. Catheter ablation of ventricular tachycardia in patients with structural heart disease using cooled radiofrequency energy: results of a prospective multicenter study. J Am Coll Cardiol 2000;35:1905–1914. - PubMed

10.4 Follow-up of Patients Post Catheter Ablation of VT

    1. Frankel DS, Mountantonakis SE, Zado ES, et al.Noninvasive programmed ventricular stimulation early after ventricular tachycardia ablation to predict risk of late recurrence. J Am Coll Cardiol 2012;59:1529–1535. - PubMed
    1. Oloriz T, Baratto F, Trevisi N, et al.Defining the outcome of ventricular tachycardia ablation: timing and value of programmed ventricular stimulation. Circ Arrhythm Electrophysiol 2018;11:e005602. - PubMed
    1. Calkins H, Epstein A, Packer D, et al.; Cooled RF Multi Center Investigators Group. Catheter ablation of ventricular tachycardia in patients with structural heart disease using cooled radiofrequency energy: results of a prospective multicenter study. J Am Coll Cardiol 2000;35:1905–1914. - PubMed
    1. Stevenson WG, Wilber DJ, Natale A, et al.Irrigated radiofrequency catheter ablation guided by electroanatomic mapping for recurrent ventricular tachycardia after myocardial infarction: the multicenter thermocool ventricular tachycardia ablation trial. Circulation 2008;118:2773–2782. - PubMed
    1. Sapp JL, Wells GA, Parkash R, et al.Ventricular tachycardia ablation versus escalation of antiarrhythmic drugs. N Engl J Med 2016; 375:111–121. - PubMed

10.5 Assessing the Outcomes of Catheter Ablation

    1. Sapp JL, Wells GA, Parkash R, et al.Ventricular tachycardia ablation versus escalation of antiarrhythmic drugs. N Engl J Med 2016; 375:111–121. - PubMed
    1. Kuck KH, Schaumann A, Eckardt L, et al.; VTACH Study Group. Catheter ablation of stable ventricular tachycardia before defibrillator implantation in patients with coronary heart disease (VTACH): a multicentre randomised controlled trial. Lancet 2010;375:31–40. - PubMed
    1. Reddy VY, Reynolds MR, Neuzil P, et al.Prophylactic catheter ablation for the prevention of defibrillator therapy. N Engl J Med 2007; 357:2657–2665. - PMC - PubMed
    1. Al-Khatib SM, Daubert JP, Anstrom KJ, et al.Catheter ablation for ventricular tachycardia in patients with an implantable cardioverter defibrillator (CALYPSO) pilot trial. J Cardiovasc Electrophysiol 2015; 26:151–157. - PubMed
    1. Stevenson WG, Wilber DJ, Natale A, et al.Irrigated radiofrequency catheter ablation guided by electroanatomic mapping for recurrent ventricular tachycardia after myocardial infarction: the multicenter thermocool ventricular tachycardia ablation trial. Circulation 2008;118:2773–2782. - PubMed

11.1.8 Ionizing Radiation

    1. Calkins H, Awtry EH, Bunch TJ, Kaul S, Miller JM, Tedrow UB. COCATS 4 Task Force 11: Training in arrhythmia diagnosis and management, cardiac pacing, and electrophysiology. J Am Coll Cardiol 2015; 65:1854–1865. - PubMed
    1. Zipes DP, Calkins H, Daubert JP, et al.2015 ACC/AHA/HRS advanced training statement on clinical cardiac electrophysiology (a revision of the ACC/AHA 2006 update of the clinical competence statement on invasive electrophysiology studies, catheter ablation, and cardioversion). Heart Rhythm 2016;13:e3–e37. - PubMed
    1. Aliot EM, Stevenson WG, Almendral-Garrote JM, et al.EHRA/HRS expert consensus on catheter ablation of ventricular arrhythmias: developed in a partnership with the European Heart Rhythm Association (EHRA), a Registered Branch of the European Society of Cardiology (ESC), and the Heart Rhythm Society (HRS); in collaboration with the American College of Cardiology (ACC) and the American Heart Association (AHA). Heart Rhythm 2009;6:886–933. - PubMed
    1. Dubin AM, Walsh EP, Franklin W, et al.Task Force 4: Pediatric cardiology fellowship training in electrophysiology. SPCTPD/ACC/AAP/ AHA. Circulation 2015;132:e75–e80. - PubMed
    1. Walsh EP, Bar-Coehn Y, Batra AS, et al.Recommendations for advanced fellowship training in clinical pediatric and congenital electrophysiology: a report from the training and credentialing committee of the Pediatric and Congenital Electrophysiology Society. Heart Rhythm 2013;10:775–781. - PubMed

11.2 Institutional Requirements for Catheter Ablation of Ventricular Tachycardia

    1. Haines DE, Beheiry S, Akar JG, et al.Heart Rhythm Society expert consensus statement on electrophysiology laboratory standards: process, protocols, equipment, personnel, and safety. Heart Rhythm 2014;11:e9–e51. - PMC - PubMed

11.3 Ventricular Tachycardia Network and Ventricular Tachycardia Unit

    1. Deneke T, Shin D-I, Lawo T, Bösche L, et al.Catheter ablation of electrical storm in a collaborative hospital network. Am J Cardiol 2011;108:233–239. - PubMed
    1. Della Bella P, Baratto F, Tsiachris D, et al.Management of ventricular tachycardia in the setting of a dedicated unit for the treatment of complex ventricular arrhythmias: long-term outcome after ablation. Circulation 2013; 127:1359–1368. - PubMed
    1. Deneke T, Müller P, Krug J, et al.Catheter ablation in patients with electrical storm: benefit of a network of cooperating clinics. Herzschrittmacherther Elektrophysiol 2014;25:105–108. - PubMed

12.1.4 Future Clinical Studies

    1. Aliot EM, Stevenson WG, Almendral-Garrote JM, et al.EHRA/HRS expert consensus on catheter ablation of ventricular arrhythmias: developed in a partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC), and the Heart Rhythm Society (HRS); in collaboration with the American College of Cardiology (ACC) and the American Heart Association (AHA). Heart Rhythm 2009;6:886–933. - PubMed
    1. Pedersen CT, Kay GN, Kalman J, et al.EHRA/HRS/APHRS expert consensus on ventricular arrhythmias. Heart Rhythm 2014; 11:e166–e196. - PubMed
    1. Al-Khatib SM, Stevenson WG, Ackerman MJ, et al.2017 AHA/ACC/ HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm 2018;15:e73–e189. - PubMed
    1. Reddy VY, Reynolds MR, Neuzil P, et al.Prophylactic catheter ablation for the prevention of defibrillator therapy. N Engl J Med 2007; 357:2657–2665. - PMC - PubMed
    1. Kuck KH, Schaumann A, Eckardt L, et al.; VTACH Study Group. Catheter ablation of stable ventricular tachycardia before defibrillator implantation in patients with coronary heart disease (VTACH): a multicentre randomised controlled trial. Lancet 2010;375:31–40. - PubMed

12.2.4 Advances in Patient Evaluation

    1. Yokokawa M, Good E, Chugh A, et al.Intramural idiopathic ventricular arrhythmias originating in the intraventricular septum: mapping and ablation. Circ Arrhythm Electrophysiol 2012;5:258–263. - PubMed
    1. Enriquez A, Supple GE, Marchlinski FE, Garcia FC. How to map and ablate papillary muscle ventricular arrhythmias. Heart Rhythm 2017; 14:1721–1728. - PubMed
    1. Yokokawa M, Morady F, Bogun F. Injection of cold saline for diagnosis of intramural ventricular arrhythmias. Heart Rhythm 2016;13:78–82. - PubMed
    1. Yokokawa M, Jung DY, Hero AO III, Baser K, Morady F, Bogun F. Single- and dual-site pace mapping of idiopathic septal intramural ventricular arrhythmias. Heart Rhythm 2016;13:72–77. - PubMed
    1. Sivagangabalan G, Pouliopoulos J, Huang K, et al.Simultaneous biventricular noncontact mapping and ablation of septal ventricular tachycardia in a chronic ovine infarct model. Circ Arrhythm Electrophysiol 2009;2:441–449. - PubMed

MeSH terms