Dr Usha Tedrow (Brigham and Women's Hospital, Boston, MA, US) discusses contemporary approaches to VT ablation in patients with complex and high-risk substrates, from preprocedural planning and mapping strategy through to long-term management.

Interview Questions:

1. How has the approach to VT ablation in high-risk substrates evolved over recent years, and what factors define a patient as high-risk?
2. What are the key considerations in preprocedural planning for this population — including imaging, substrate characterisation, and patient optimisation?
3. How do you approach mapping strategy in complex substrates, and how does this influence your ablation approach?
4. When should epicardial access be considered, and how does that decision affect procedural planning and risk?
5. How do you manage haemodynamic instability during VT ablation procedures, and what support strategies are available?
6. What does long-term management look like following successful ablation — and how do you define and monitor for success?
7. What are your take-home messages for electrophysiologists managing patients with VT in challenging substrate?

Recorded on-site at HRS Congress 2026, Chicago.
Editor: Jordan Rance
Videographer: Oliver Miles, David Ben-Harosh
Support: This is an independent interview produced by Radcliffe Cardiology.