Current Heart Failure Reports

, Volume 15, Issue 4, pp 201–213 | Cite as

Decompensated Heart Failure With Ventricular Arrhythmia: How Useful Is VT Ablation?

  • Gerasimos Dimitropoulos
  • Georgios Leventogiannis
  • Joseph De BonoEmail author
Decompensated Heart Failure (P Banerjee, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Decompensated Heart Failure


Purpose of Review

Ventricular arrhythmias are common in patients with heart failure. Their management especially in the context of decompensated heart failure poses a clinical challenge to modern cardiologists. In this review article, we aim to summarise the current evidence on the epidemiology, pathophysiology, and management of ventricular tachycardia in heart failure, focusing primarily on the use of catheter ablation.

Recent Findings

The evolution of electro-anatomical mapping techniques and ablation catheter technology in the recent years has paved the path for the successful application of catheter ablation in the treatment of ventricular arrhythmias. The efficacy of catheter ablation in the management of ventricular tachycardia in patients with chronic heart failure has recently been the epicentre of a number of randomised controlled trials, demonstrating promising results with regard to arrhythmia suppression and all-cause mortality. The usefulness of catheter ablation in decompensated heart failure has been explored to a lesser degree, primarily in the setting of an electrical storm.


Implantable cardiac defibrillators play the most important role in improving prognosis and preventing sudden cardiac death in patients with heart failure. Catheter ablation for the treatment of recurrent VT in patients with chronic heart failure is an efficacious strategy that can be applied adjunctively to or in instead of antiarrhythmic therapy, and it is highly successful at preventing recurrent ventricular tachycardia, ICD shocks. Its efficacy in the context of decompensated heart failure requires further research, with current evidence rendering its use promising.


Ventricular tachycardia Catheter ablation Heart failure Electrical storm Structural heart disease Amiodarone 


Compliance with Ethical Standards

Conflict of Interest

Gerasimos Dimitropoulos declares no conflicts of interest.

Georgios Leventogiannis reports support from Biotronik.

Joseph De Bono reports support from Boston Scientific and Biosense.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major Importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Gerasimos Dimitropoulos
    • 1
  • Georgios Leventogiannis
    • 1
  • Joseph De Bono
    • 1
    Email author
  1. 1.Cardiology DepartmentUniversity Hospital BirminghamBirminghamUK

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