Although implantable cardioverter-defibrillators positively affect survival in patients at increased risk for arrhythmic sudden cardiac death, quality of life can be negatively affected by recurrent therapies. Ventricular tachycardia (VT) ablation targets clinical arrhythmias to prevent recurrence. Although treatment of VT initially required open heart surgery, it has since been replaced by percutaneous ablation, a safe and effective catheter-based therapy to ablate myocardium from either the endocardial or the epicardial surface.

Editor-in-Chief
David J. Wilber, MD, FACC

CME Editor
Smit Vasaiwala, MD

Authors
Gustavo S. Guandalini, MD
Jackson J. Liang, DO
Francis E. Marchlinski, MD

CME Information
Target Audience
JACC Journal CME is intended for physicians who treat patients with cardiovascular disease.

Important Dates
Date of Release: December 16, 2019
Term of Approval/Date of CME/MOC/ECME Expiration: December 15, 2020

Learner Objectives
After reading this article the reader should be able to:

• Evaluate treatment options for patients with ischemic heart disease and recurrent ventricular tachycardia (VT) despite antiarrhythmic drugs.
• Discriminate different VT circuit components based on entrainment mapping.
• Locate the likely sites of origin for ventricular premature depolarizations based on 12-lead electrocardiogram characteristics.
• Correlate predicted exit sites for VT based on 12-lead electrocardiogram characteristics with substrate characterization by cardiac magnetic resonance imaging.
• Predict impact in radiofrequency ablation lesion size with employment of impedance modulation strategies and lower ionic irrigants.

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