# The Role of Imaging in Ventricular Tachycardia Ablation

## TL;DR

This paper reviews how cardiac imaging helps improve the success of ablation procedures for ventricular tachycardia.

## Contribution

The paper provides a comprehensive review of multimodal imaging's role in enhancing VT ablation strategies.

## Key findings

- Multimodal imaging improves substrate identification and anatomical delineation in VT ablation.
- Imaging aids procedural efficacy and safety by offering real-time guidance during ablation.
- Limitations include costs, artifacts, and lack of standardization in imaging techniques.

## Abstract

Ventricular tachycardia (VT) remains a major cause of morbidity and mortality in patients with structural heart disease. While catheter ablation has become a cornerstone in VT management, recurrence rates remain substantial due to limitations in electroanatomic mapping (EAM), particularly in cases of deep or heterogeneous arrhythmogenic substrates. Cardiac imaging, especially when multimodal and integrated with mapping systems, has emerged as a critical adjunct to enhance procedural efficacy, safety, and individualized strategy. This comprehensive review explores the evolving role of various imaging modalities, including echocardiography, cardiac magnetic resonance (CMR), computed tomography (CT), positron emission tomography (PET), and intracardiac echocardiography (ICE), in the preprocedural and intraprocedural phases of VT ablation. We highlight their respective strengths in substrate identification, anatomical delineation, and real-time guidance. While limitations persist, including costs, availability, artifacts in device carriers, and lack of standardization, future advances are likely to redefine procedural workflows.