ABSTRACT
Introduction Catheter ablation of VF: basic principles Catheter ablation of idiopathic VF Catheter ablation of ischemic VF and polymorphic VT Catheter ablation of ventricular fibrillation associated with long QT and Brugada syndrome Summary and conclusions
INTRODUCTION Sudden cardiac death (SCD) remains the leading cause of death in the United States and industrialized world. The majority of sudden cardiac death is caused by ventricular fibrillation (VF) associated with structural and ischemic heart disease. Over the last decade, much time and research has been devoted to the development of implantable cardioverter defibrillators (ICDs). After several multi-center trials demonstrated survival benefit in populations resuscitated from SCD, initial application of this technology centered on secondary prevention.1-3
Indication for ICD implantation expanded further after benefit was demonstrated in populations with ischemic and non-ischemic cardiomyopathy who had ICDs placed for primary prophylaxis.4-6 The recent increase in ICD use has been demonstrated to be cost effective,7 but ICDs remain a large concern from an economic standpoint. Estimates reflect that with current inclusion criteria, approximately 500 000 Medicare beneficiaries now qualify for ICDs.7
