Radiofrequency Ablation Strategies for Intramural Ventricular Arrhythmias

Methodist Debakey Cardiovasc J. 2021 Apr 5;17(1):8-12. doi: 10.14797/PEYF3776. Epub 2021 Mar 25.


Catheter ablation is an established treatment strategy for ventricular arrhythmias. However, the presence of intramural substrate poses challenges with mapping and delivery of radiofrequency energy, limiting overall success of catheter ablation. Advances over the past decade have improved our understanding of intramural substrate and paved the way for innovative treatment approaches. Modifications in catheter ablation techniques and development of novel ablation technologies have led to improved clinical outcomes for patients with ventricular arrhythmias. In this review, we explore mapping techniques to identify intramural substrate and describe available radiofrequency energy delivery techniques that can improve overall success rates of catheter ablation.

Keywords: catheter ablation; intramural origin; radiofrequency ablation; ventricular arrhythmia.

Publication types

  • Review

MeSH terms

  • Action Potentials
  • Catheter Ablation* / adverse effects
  • Electrocardiography
  • Electrophysiologic Techniques, Cardiac
  • Heart Conduction System / diagnostic imaging
  • Heart Conduction System / physiopathology
  • Heart Conduction System / surgery*
  • Heart Rate*
  • Humans
  • Magnetic Resonance Imaging
  • Predictive Value of Tests
  • Tachycardia, Ventricular / diagnosis
  • Tachycardia, Ventricular / physiopathology
  • Tachycardia, Ventricular / surgery*
  • Treatment Outcome
  • Ventricular Fibrillation / diagnosis
  • Ventricular Fibrillation / physiopathology
  • Ventricular Fibrillation / surgery*