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Catheter Ablation of Ventricular Tachycardia in Patients with Post-Infarction Cardiomyopathy
Babak Nazer,Edward P Gerstenfeld 대한심장학회 2014 Korean Circulation Journal Vol.44 No.4
Monomorphic ventricular tachycardia (VT) in patients with post-infarction cardiomyopathy (CMP) is caused by reentry through slowly con-ducting tissue with in areas of myocardial scar. The use of implantable cardioverter-defibrillators (ICDs) has helped to decrease the risk ofarrhythmic death in patients with post-infarction CMP, but the symptomatic and psychological burden of ICD shocks remains significant. Experience with catheter ablation has progressed substantially in the past 20 years, and is now routinely used to treat patients with post-infarction CMP who experience VT or receive ICD therapy. Depending on the hemodynamic tolerance of VT, a variety of mapping techniquesmay be used to identify sites for catheter ablation, including activation and entrainment mapping for mappable VTs, or substrate map-ping for unmappable VTs. In this review, we discuss the pathophysiology of VT in post-infarction CMP patients, and the contemporarypractice of catheter ablation.