Ventricular Tachycardia in Structurally Normal Hearts

Ventricular tachycardia with structurally normal hearts’ manifold clinical presentations is considered predominantly benign but in actuality it is associated with increased risk of cardiovascular events in epidemiologic studies. Malignant presentations including reversible cardiomyopathy or sudden death are well established. Risk stratification depends on careful assessment of cardiac morphology and structure to rule out subclinical heart disease and electrocardiographic characteristics. Arrhythmia mechanisms and treatment strategies are ascertained from the electrocardiographic and electropharmacologic profiles; however, the mechanisms for pathogenicity are poorly understood. Catheter ablation is curative with improved outcomes compared to pharmacotherapy; however, the efficacy and safety differ significantly by anatomic origin.