Sharing the Journey

      Figure thumbnail fx1
      Jordan M. Prutkin, MD, MHS, Consulting Editor
      Figure thumbnail fx2
      Emily P. Zeitler, MD, MHS, Consulting Editor
      This journal has focused on review articles that go in-depth on an important or emerging subject. The first issue in 2009 included an article by Conor Barrett, MBBCH, and coauthors entitled “Ventricular Tachycardia Ablation—For Whom, When, and How?” In the subsequent 13 years, those questions are far from settled, but so much has changed. We now present an entire issue on the topic, “Interventional Management of Ventricular Arrhythmias.” Thus, a topic that warranted a single review article in 2009 inspired 18 articles in this issue 13 years later. We have come a long way!
      We are thankful to Drs Auras Atreya and Calambur Narasimhan, who edited and guided this issue, and to the numerous authors for their outstanding contributions. This issue takes the readers on a journey through the ablation of ventricular arrhythmias. It includes articles that describe the underlying substrate of ventricular arrhythmias, including mechanisms and imaging. These critical, underlying pathophysiologic discussions, which inform preablation preparation, include a thorough understanding of why the patient is having ventricular arrhythmias to improve the likelihood of success. The issue then explores how to approach ablation for various substrates, including normal hearts, His-Purkinje arrhythmias, epicardial disease, arrhythmogenic right ventricular cardiomyopathy, Brugada syndrome, hypertrophic cardiomyopathy, granulomatous myocarditis, and adult congenital heart disease. Ablation of ventricular fibrillation is discussed as well, with a focus on the elimination of the triggering premature ventricular contractions. Last, there are several articles about ablation using alternative energy sources. Four of these final five articles discuss novel technologies still undergoing testing, and they show us where interventional electrophysiology could be going in the future. This includes the use of alcohol in the arterial or venous systems, pulsed field ablation, neuromodulation, and stereotactic radiotherapy. All of these new technologies have unanswered questions related to safe and effective use, and these articles review the current knowledge and techniques. Surgical ablation is also considered with attention paid to its ongoing use in some specific clinical scenarios.
      We look forward to sharing the journey of this journal with you. We hope that you, Reader, will reach out to us if you have ideas for an issue or a specific contribution.