Ventricular tachycardia ablation and substrate modification in ICD patients with electrical storm

The electrical storm (ES) is defined as a state of electrical instability with three or more sustained ventricular arrhythmias (VAs) occurring within twenty-four hours, which needs intravenous antiarrhythmic medications and frequent defibrillation. Recently, radiofrequency catheter ablation evolved as a sole therapy to terminate ES in patients with ICD, and the survival has been reported to be improved with successful ablation during follow-up. In this review, we briefly summarize substrate mapping and substrate ablation strategy in patients with ES, and discuss the reason of recurrence after ablation.