Ablation of Catecholaminergic Polymorphic Ventricular Tachycardia

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a lethal arrhythmogenic disease characterized by syncope or sudden cardiac death induced by exercise or emotional stress in individuals without organic heart disease. The cause of CPVT is reported to be a gene mutation in RYR2 or CASQ2, and its prognosis is considered to be poor. Various types of adrenergic-induced arrhythmias, including not only ventricular but also supraventricular arrhythmias, are accompanied by and result in syncope or sudden cardiac death. Notably, bidirectional ventricular tachycardia is unique to this disease. The therapeutic management of CPVT primarily includes exercise restriction, beta-blockers, and implantable cardioverter defibrillator implantation, and the main purpose of therapy is to prevent sudden cardiac death caused by fatal arrhythmia. Catheter ablation is regarded as one of the most effective therapies for CPVT patients with drug refractory arrhythmias. Some case reports describing successful ablation of ventricular arrhythmias or atrial tachycardia/atrial fibrillation have been published; however, the data remains limited as no large cohort studies have been performed and the long-term success rate is unclear. Further investigation is required to elucidate the feasibility of ablation for ventricular and supraventricular arrhythmias.