Ablation Methods and Catheter Settings for Ventricular Tachycardia Ablation: A Bench to Bedside Review: Part 2.
Niespialowska-Steuden, Maria Silberbauer, John Al-Sheikhli, Jaffar Siang, Rafaella Mayer, Joseph Dhanjal, Tarvinder
Niespialowska-Steuden, Maria
Silberbauer, John
Al-Sheikhli, Jaffar
Siang, Rafaella
Mayer, Joseph
Dhanjal, Tarvinder
Abstract
Catheter ablation remains a cornerstone in the treatment of ventricular tachycardia (VT) in structural heart disease. Part 1 of this review focused on the principles and technical aspects of radiofrequency (RF) ablation. Part 2 explores alternative strategies designed to overcome the limitations of conventional RF, in particular, achieving transmurality in complex or deep intramuscular substrates. We critically evaluate the mechanisms, evidence and clinical applications of bipolar RF ablation, pulsed-field ablation (PFA), ultra-low-temperature cryoablation (ULTC) and venous ethanol and needle ablation. Despite the rapid expansion ofthe technological armamentarium, current clinical evidence remains limited. The data supporting long-term safety and durability are predominantly based on preclinical and small observational studies. We advocate for continued investigation into these specialised techniques to provide a more tailored, patient-specific approach to VT management.
Affiliations
Department of Cardiology, University Hospital Southampton NHS Trust Southampton, UK; Department of Cardiology, University Hospital of Coventry and Warwickshire NHS Trust Coventry, UK; Department of Cardiology, Royal Sussex County Hospital Brighton, UK; et al.
Date
2026-05-06
Type
Article
Collections
Citation
Arrhythm Electrophysiol Rev . 2026 May 6:15:e19