In arrhythmia therapy, new and innovative technologies have emerged in the field of catheter ablation and cardiac devices, however the usefulness and limitations have not become fully recognized.

1)Catheter Ablation
Recording othecardiac propagation during tachyarrhythmias is not clear in patients with an arrhythmogenic substrate such as with an infarction, fibrosis, or scar tissue. In those cases, a “ripple mapping system” enables an intuitive visual image through an automated and high-density recording of the electrical activity projected on a 3D image. This will be useful for the ablation of atrial fibrillation and tachycardias with a complex substrate. In structural VT, a low-voltage area in the scar region or the marginal area around it is likely to be the origin of the VT or part of the reentrant VT circuit. The anatomical substrate is precisely mapped and analyzed by MRI. Currently catheter ablation cannot yet be performed under MRI recording, but a real-time MRI ablation system is expected to be available within the next couple of years.
Refractory VTs resistant to conventional therapy have been reported to be cured by myocardial ablation using the Cyber-knife that is usually applied to cure cancer. This noninvasive and powerful ablation system is noteworthy as a near-future therapy.

2)Cardiac devices
Since the clinical data on leadless PM implantation has been accumulated in 2,000 Japanese patients, it is appropriate to assess its efficacy and safety.His-bundle pacing, a new system allowing for a physiological ventricular contraction, is regarded as a promising tool, however it is not clear whether HB pacing will be a substitute device for CRT or whether it is applicable in CRTD cases.
In this plenary session, the physicians/researchers working on above new therapies will demonstrate their clinical experience and share their expertise in the arrhythmia therapy clinical setting using these new and innovative systems and devices.