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Ventricular tachycardia in the setting of cardiomyopathy are the most common forms of ventricular tachycardia. In patients with prior myocardial infarction, the patients are felt to have ischemic cardiomyopathy. The myocardial infarction may have a central area of scar surrounded by islands of scar interspersed with living tissue. These channels of living tissue are felt to be the pathways or corridors for electrical signals to travel. Most ventricular tachycardias in the setting of cardiomyopathy are felt to be reentrant, meaning that they take a roughly circular path over and over again.
Patients with cardiomyopathy and ventricular tachycardia are treated with an implantable defibrillator because of the risk of sudden cardiac death. Patients with ischemic and nonischemic cardiomyopathy may have a variable frequency of recurrent ventricular tachycardia. Patients with multiple VT shocks are typically good candidates for ventricular tachycardia ablation. Generally the patients are ambulatory without advanced and progressive heart failure.