Cor Vasa 2025, 67(5):620-630 | DOI: 10.33678/cor.2025.064

(Non-Pharmacological Management of Ventricular Tachycardias in a Complex Cardiovascular Center)

Filip Schlosser^{a, b}, Petr Peichl^a, Josef Kautzner^a

^a Klinika kardiologie, Institut klinické a experimentální medicíny, Praha, Česká republika

^b 3. lékařská fakulta Univerzity Karlovy v Praze, Praha, Česká republika

Ventricular arrhythmias significantly influence morbidity and mortality in patients with structural heart dis- ease. Implantable cardioverter-defibrillators positively affect survival but do not prevent ventricular arrhythmias. Until recently, the cornerstone of management of ventricular arrhythmias was administration of antiarrhythmic drugs, which have limited efficacy and non-negligible side effects. Nowadays, newer non-pharmacological treatment modalities have emerged, namely catheter ablation. Radiofrequency energy is considered the gold standard and its effect can be further augmented by using different types of catheters, alternative perfusion agents, or modified ablation techniques. Alternatively, cryoablation or pulse field ablation make a promise for the future as pulse field ablation has already become an established treatment strategy for managing atrial fibrillation. Additionally, alcohol ablation by administering concentrated ethanol into coronary arteries or veins subtending blood flow to the arrhythmogenic substrate may be used in a selected population. Newer non-invasive treatment method is stereotactic arrhythmia radiotherapy, especially for patients after catheter ablation failure. The aim of this review is to summarize up-to-date non-pharmacological treatment options for ventricular tachycardias.

Keywords: Alcohol ablation, Catheter ablation, Cryoablation, Pulsed field ablation, Stereotactic arrhythmia radiotherapy, Ventricular tachycardia

Received: March 29, 2025; Revised: March 29, 2025; Accepted: May 1, 2025; Prepublished online: June 2, 2012; Published: November 6, 2025  Show citation