Sustained Ventricular Tachycardia in Apparently Normal Hearts: Ablation Should Be the First Step in Management

Patients without structural heart disease tend to have fewer morphologies of ventricular tachycardia, with automaticity and triggered activity a more common mechanism than re-entry associated with extremely low risk of sudden death. Ablation can be curative in patients with a single morphology of ventricular tachycardia that is focal in origin, particularly in patients without overt structural heart disease. There are limited data in secondary prevention implantable cardioverter defibrillator literature to support the routine implementation of implantable cardioverter defibrillator in normal hearts. Antiarrhythmic drugs have not been shown to reduce all-cause mortality in patients with and without structural heart disease.