Advances in transcatheter endocardial mapping and radiofrequency ablation of ventricular arrhythmias

Transcatheter localization (‘mapping’) of critical conduction regions, followed by radiofrequency (RF) energy delivery for targeted ablation of appropriate cardiac tissues, have proved highly successful for eliminating susceptibility to the most common types of paroxysmal reentrant supraventricular tachycardias (i.e., reentry within the AV node and reentry utilizing accessory pathways). Similarly, specialized forms of ventricular tachycardia (bundle-branch reentry, right ventricular outflow tract tachycardia, and certain idiopathic left ventricular tachycardias) can be readily mapped and treated by these techniques [1–4]. In contrast, conventional transcatheter mapping and RF ablation have proven less reliable in the setting of paroxysmal ventricular tachycardia associated with the most prevalent forms of structural heart disease, particularly ischemic heart disease [1, 5, 6].