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Ventricular Tachycardia Ablation

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Image illustration of Ventricular Tachycardia compared to a normal heart with their signals.
Image Credit: mayoclinic.org
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Understanding Ventricular Tachycardia (VT) Ablation

Through the skilful use of heat energy (RF Ablation), Ventricular Tachycardia ablation creates precise micro-scars within your heart, effectively blocking faulty signals responsible for rapid and irregular heartbeats. This remarkable treatment targets the condition known as Ventricular Tachycardia, which occurs when abnormal electrical signals disrupt the natural rhythm of the heart's lower chambers, the ventricles.

The primary objective of Ventricular Tachycardia ablation is to achieve a healthy and regular heart rhythm, ensuring optimum cardiac function. One highly effective technique in this realm is radiofrequency catheter ablation, which has emerged as a prominent solution for managing ventricular arrhythmias. This procedure has proven to be an exceptional choice for patients who have not experienced satisfactory results with medications, struggle with medication tolerability, or simply prefer a non-pharmacological approach.

At our esteemed institution, Dr Karthigesan leads the way in VT ablation procedures. With extensive expertise and a commitment to patient care, Dr Karthigesan offers a superior level of skill and precision, delivering outstanding outcomes that enhance the quality of life for each patient.

Image illustration of Ventricular Tachycardia (VT) Ablation procedure.
Image Credit: mayoclinic.org
A bisection image of the heart.
Image Credit: mayoclinic.org

The Potential of Cardiac Ablation: Types of Arrhythmias Treated

Cardiac ablation has emerged as a powerful tool in the treatment of various arrhythmias and select structural heart conditions. In addition to its effectiveness in ventricular tachycardia (VT) ablation, this innovative technique can successfully address a spectrum of supraventricular arrhythmias, expanding its therapeutic reach to provide comprehensive care. The types of arrhythmias that can be effectively treated with cardiac ablation include:

Evaluation for Ventricular Tachycardia (VT) Ablation

If you are preparing for Ventricular Tachycardia (VT) Ablation, you need to consult with Dr Karthigesan first. He will conduct a thorough review of your medical history. As part of the preparation process, you may have to comply with the following pre-procedural steps:

  • Opt for a blood analysis approximately one week before the scheduled procedure.
  • Depending on your individual case, you may have to undergo a Computerized Tomography (CT) or Magnetic Resonance Imaging (MRI) scan of your heart if the doctors recommend the same.
The image compares the normal heart rhythm with Ventricular Tachycardia.
Image Credit: healthlibrary.askapollo.com
The scan image of the ventricular tachycardia monitoring.
Image Credit: ahajournals.org
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Ventricular Tachycardia (VT) Ablation Process

Ventricular Tachycardia (VT) Ablation is a complex procedure meticulously executed with the objective of eradicating the origin of the VT. The process is systematically performed as follows:

  • Initiation of the procedure involves the introduction of a slender, elongated catheter into the heart chambers via the groin, with the aim of pinpointing the precise locations contributing to the VT circuit.
  • Upon the identification of critical areas, radiofrequency energy is applied to a small area, typically 4-5 mm in diameter. This energy serves to obliterate the anomalous tissue, thereby reducing the likelihood of VT recurrence.
  • The procedure can be time-consuming, with an average duration ranging from 3 to 4 hours.

Enhanced precision is achieved during the procedure using innovative 3D mapping technology such as the CARTO or ENSITE system. Dr Karthigesan is one of the pioneers in using 3D mapping technology in India. At our clinic, we are equipped with the facility to use one of the latest technology in the world today- CARTO 3 Version 7. It is a highly precise technology that can easily identify the location of arrhythmia with one millimeter accuracy and enhance the success rate of ablation

  • This advanced technology facilitates the precise identification and elimination of abnormal electrical focus in the heart.
  • It aids in the delivery of radiofrequency energy with a remarkable accuracy of 1 mm to the desired spot, effectively eliminating the abnormal focus.
  • The technology minimises the need for X-rays by allowing the catheters to be manoeuvred within your heart seamlessly and helps in the creation of an electrical map of the VT circuits.

Upon successful identification and localisation of the VT circuits and abnormal tissue, the radiofrequency ablation is applied to the targeted area. However, the duration of a scar-related VT ablation procedure may vary depending on numerous factors, such as the seriousness of structural heart disease and the number of VT circuits.

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Before/During/After the Procedure- Points to Note

Before the Procedure

During the Procedure

After the Procedure

  • Medications specifically prescribed for your abnormal heart rhythm might need to be discontinued 5 days before the procedure.
  • If you are on any anticoagulation (blood thinning) medications, these should be stopped one week prior to your procedure.
  • Fasting is required for at least six hours before the procedure.
  • Pre-operative checks will be carried out, and the groin area where the catheter is to be placed will be shaved.
  • Multiple ECG monitoring electrodes will be adhered to your chest area, with additional patches positioned on your chest and back.
  • The procedure may be conducted under local anaesthesia with sedative medication or under full general anaesthesia.
  • In the case of local anaesthesia, the doctor will administer the anaesthetic to the groin area where the catheters will be placed.
  • A mandatory resting period of 6 hours, during which you must lie flat, is required post-procedure. A hospital stay of 1 to 2 nights is typically needed.
  • During the resting period, it is crucial to maintain your legs in a straight position, and your head relaxed on the pillow.
  • Activities such as exercise, driving, and heavy lifting should be avoided for 5 days after the procedure.
  • A follow-up appointment will be arranged to assess your post‑procedure progress.
Benefits of Ventricular Tachycardia Ablation
  • RF Catheter Ablation offers a highly effective treatment solution for patients experiencing VT in conjunction with structural heart disease.
  • Demonstrably, Catheter Ablation significantly reduces VT burden and decreases the instances of necessary Implantable Cardioverter Defibrillator (ICD) therapies.
  • While Antiarrhythmic Drugs (AADs) can effectively manage VT, their long-term usage may lead to considerable side effects, making RF Ablation a safer option for many patients.
  • With continual enhancements in technology and procedural techniques, Catheter Ablation for VT has emerged as an increasingly preferred treatment strategy.
Decorative red spiral.Decorative green rectangle.Decorative blue rectangle.
It’s Time to
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Don't let irregular heart rhythms dictate your life. Take a stride towards a healthier heart with Ventricular Tachycardia Ablation at Dr Karthigesan Clinic.
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Catheter Ablation for Ventricular Tachycardia- Your Queries, Our Answers

Radiofrequency (RF) catheter ablation was initially employed in cases where patients with recurrent VT (VT storm) were experiencing multiple Implantable Cardioverter Defibrillator (ICD) shocks. Nowadays, due to advancements in 3D mapping technology and a higher rate of success, it is being utilised more frequently and earlier in the management of VT. This helps avoid repeated ICD shocks and the use of potentially harmful antiarrhythmic medications.

Catheter ablation therapy is recommended for:

  • Patients for whom medications are no longer effective or tolerated.
  • Patients who get VT at a young age. Catheter ablation therapy helps avoid long term medical therapy in such cases.
  • Patients with VT along with episodes of loss of consciousness or life threatening symptoms.

3D mapping technology significantly enhances the success rate of RF catheter ablation procedures. It provides a more accurate guide for the process, improving outcomes while also reducing the patient's exposure to radiation. The recent integration of contact force sensing catheters into 3D mapping technology has further amplified the success rate of RF ablation.

Dr Karthigesan is one of the pioneers in India when it comes to the use of 3D mapping technology. Our clinic is equipped with one of the latest technologies in the world today- CARTO 3 Version 7. It provides one millimeter accuracy in identifying arrhythmia locations and increases ablation success rates

Structural heart disease refers to any issues associated with the heart muscle tissues (for instance, scars resulting from an old heart attack or infection), heart valves, or the blood supply to the heart muscles (like blockages in the coronary artery). Scar tissue, or fibrosis, can disrupt the normal electrical impulse in the heart, leading to a short circuit of the rhythm, a condition known as VT. Ventricular Tachycardia linked to structural heart disease can be life-threatening, potentially leading to sudden cardiac arrest.

In certain cases, Dr Karthigesan may determine that the VT originates from a circuit located on the heart's outer surface or the epicardium. If this is the case, a puncture is made into the sac (the pericardium) surrounding the heart, right beneath the breastbone. This allows the ablation catheter to be inserted and manoeuvred within the pericardium to establish whether the VT originates there.

Recurrence of VT depends on the underlying structural heart disease. If you do not have any structural heart diseases, the chances of recurrence are less than 10%. But, if you have structural heart disease, the chances of recurrence are more and it depends on the severity of the structural heart disease. It can vary between 19% to 50%. Multiple morphologies of VT and unstable VTs are associated with a higher risk of recurrence. In situations where endocardial ablation is unsuccessful, it could be due to epicardial reentry or intramural circuits.

There are three different treatment options for VT:

  • Medical therapy
  • Radiofrequency Catheter Ablation therapy
  • AICD (Automatic Implantable Cardioverter Difribrillater) implantation

Yes. VT can occur in a structurally normal heart due to various unknown reasons.

AICD implantation is usually done to prevent sudden cardiac arrest in structurally abnormal heart and in rare cases for structurally normal heart. It is also done in the rare occasion when VT is associated with genetic disorders or idiopathic AF.

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