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Format: 04/18/2014
Format: 04/18/2014


Treatment for Ventricular Tachycardia


Heart specialists at Allegheny General Hospital have joined a select group of physicians nationwide who offer a new, minimally invasive therapy called epicardial ventricular tachycardia (VT) ablation.

One of the leading causes of sudden cardiac death, VT is an abnormal, rapid heart rhythm that starts in the heart’s ventricles and is caused by tissue that disrupts the heart’s electrical system. The condition makes the heart considerably less efficient, and without treatment it can lead to heart failure and cardiac arrest.

Although a number of treatment options exist for VT, including medications and surgical intervention, epicardial VT ablation is a promising option for patients whose heart rhythm disturbance originates close to or on the surface of the heart – an area called the epicardium.

Epicardial VT ablation involves directing a catheter to the epicardium via a small puncture in the skin near the lower end of the breast bone. Radiofrequency energy (low-voltage, high-frequency electricity) is then applied through the catheter to the targeted area to ablate, or burn off, the abnormal tissue so that it is no longer capable of generating or conducting electrical impulses.

“We are very excited to have this newer, advanced capability for treating some of our patients with VT,” said William Belden, MD, an AGH electrophysiologist. “Epicardial VT ablation is a sophisticated technique that requires considerable experience and skill to perform safely, but for those patients who are good candidates, it can be an extremely effective and minimally invasive cure for their disease.”

According to Dr. Belden, medications are often used to treat VT; however, only about half of patients treated medically experience sustained relief and many drugs cause serious side effects. The condition can also be treated by placing an implantable defibrillator in the patient’s chest to shock the heart back into normal rhythm when necessary.

“The variety of treatment options available to patients with VT and other heart rhythm disorders, such as atrial fibrillation, underscores the importance of seeking care at the most experienced, capable and best-equipped medical centers,” said Christopher Bonnet, MD, director, AGH Division of Electrophysiology.

Under Dr. Bonnet’s leadership, AGH’s nationally recognized Cardiovascular Institute is one of the region’s preeminent programs for the diagnosis and treatment of heart arrhythmias. The Institute’s team of cardiologists and cardiac surgeons provides state-of-the-art testing (including electrophysiology studies, electrocardiograms, holter monitoring and more), medical therapy (the newest generation of drugs to treat irregular heartbeat), interventional therapy (procedures such as hybrid ablation, radiofrequency ablation and pulmonary vein isolation), device therapy (implantable pacemakers and defibrillators) and surgery (both open-heart and minimally invasive techniques).

In addition to pioneering the use of epicardial VT ablation locally, AGH doctors are also among just a handful of specialists in the country performing hybrid cardiac ablation to treat atrial fibrillation. The groundbreaking technique combines catheter ablation with minimally invasive surgical ablation to more fully penetrate and treat all layers of the cardiac tissue causing the irregular heart rhythms.

“Cardiac ablation is a viable treatment alternative that helps many patients with arrhythmias resume a normal, symptom-free life,” said Dr. Bonnet. “Whether done surgically, percutaneously, via the new epicardial approach or with some combination of the three, it is a proven therapy that leading heart care centers like AGH perform on a routine basis.”

AGH’s heart rhythm disorders team includes Drs. Belden and Bonnet; electrophysiologists John Chenerides, MD, Kenneth Judson, MD, and Amit Thosani, MD; and cardiovascular surgeons Robert Moraca, MD, and Thomas Maher, MD.

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