How VT ablation saved one man’s life—and what it could mean for yours
Hear from a patient and learn from a UI Health Care expert what to expect, what questions to ask, and how to know if a ventricular tachycardia ablation is the right choice for you.
Ventricular tachycardia (VT) ablation is a procedure used to treat potentially life-threatening heart rhythm disturbances that originate in the ventricles—the heart’s lower chambers. Using catheters inserted through blood vessels and guided into the heart, physicians deliver energy (typically radiofrequency heat) to ablate—or destroy—the tissue that causes the arrhythmia.
Paari Dominic, MBBS, MPH, a cardiac electrophysiologist at UI Health Care, explains that because VT ablation is more complex than other cardiac ablations, physicians follow specific criteria to determine if a patient is a good candidate for the procedure.
One of those patients was Dean Ruther, a 64-year-old Iowan and retired air traffic controller. Despite having no symptoms, Ruther’s dangerously high heart rate was first detected remotely by his care team.
“I felt great,” Ruther recalls. “But my heart was racing at 180, and I didn’t even know it.”
What began as a confusing situation quickly became an emergency, leading to a lifesaving ablation at UI Health Care.
About 60 to 80% of patients don’t have another VT episode after ablation.
A patient's journey: Deciding on VT ablation
Ruther was no stranger to heart issues. After surviving a heart attack at age 38 and receiving a stent, he lived for years with a pacemaker and defibrillator. But it wasn’t until his heart rate spiked to dangerous levels—without any noticeable symptoms—that he found himself in a life-threatening episode of ventricular tachycardia (VT).
“I never felt any symptoms,” Ruther recalls. “The only reason I even knew something was going on was because the EP clinic called me and said, ‘We’ve seen a high heart rate.’ I felt fine.”
Still, when his heart rate hovered around 180 beats per minute for several days, Ruther’s daughter—a nurse practitioner—urged him to get to the emergency room at a Cedar Rapids, Iowa, hospital. His fiancée, Denise Roberts, didn’t hesitate.
“I just said, ‘Give me the keys. Let’s go,’” Roberts says.
What followed was a series of attempts to stabilize Ruther’s heart rate with medication, followed by an unsuccessful emergency ablation. That’s when the care team in Cedar Rapids told him he’d need more specialized care.
“I was scared. When the first ablation didn’t work, I started thinking, ‘What if they can’t fix this?’” Ruther says.
He remembers lying in the hospital bed, praying.
“I told God, ‘If you want me, I’m ready. But if not, fix me up—because I’ve still got a lot of life I want to live,’” he says. “The [Cedar Rapids] doctor said, ‘If it can be done, Dr. Dominic can do it.’ I didn’t hesitate. I knew we had to try.”
The patient's perspective: Life after ablation
The second ablation attempt—this time at UI Health Care with Dominic—was successful for Ruther. The difference was immediate.
“Before the ablation, my ejection fraction [a measurement that shows how much blood the left ventricle pumps out with each contraction] was down to 25%,” Ruther says. “My heart just wasn’t pumping efficiently. Now it’s up 10% already—and climbing. For the first time since I got my pacemaker, there were no episodes. That’s huge.”
Ruther says he’s back to working on his family’s corn, soybean, and cow farm, taking long walks with Roberts, and simply appreciating life.
“You go through something like that, and it changes you,” he says. “We’re eating better, staying active, and just enjoying every day.”
Ruther’s advice for anyone considering VT ablation?
“Do it. Absolutely do it. It saved my life,” he says
Talk to a Heart Rhythm Specialist
If you or a loved one is living with ventricular tachycardia (VT), our expert team at Ui Health Care can help you explore whether ablation is the right option.
What to expect from the procedure
Doctors follow specific guidelines to decide if a person is a good fit for VT ablation. One important factor is the patient’s specific type of ventricular tachycardia. If the irregular heart rhythm lasts for a longer time—called sustained monomorphic VT—ablation may be recommended. But if the rhythm starts and stops quickly (paroxysmal VT), it usually isn’t treated with ablation.
Before offering the procedure, doctors almost always try at least one antiarrhythmic medication.
“If the VT continues even after taking that medicine, then we consider ablation,” Dominic explains.
Because ablation carries some risk, a patient’s overall health is also important.
“We want to make sure the patient is healthy enough to have this done,” Dominic says.
VT ablation is done under general anesthesia, so patients are completely asleep. Doctors insert thin tubes called catheters through blood vessels in the groin and guide them into the heart. Using a tool called an electro-anatomical map, they find the part of the heart muscle causing the abnormal rhythm.
“We’re actually burning the heart muscle,” Dominic explains. “It’s a kind of injury to the heart, destroying unhealthy heart muscle that helps the patient in the long run.”
Sometimes the ablation is done from inside the heart (called endocardial), but in more complex cases, doctors may need to treat the outer surface (epicardial) or use a special kind of alcohol to reach the right spot (alcohol ablation).
After the procedure, patients often feel tired or worn out for about a week. The groin area may be sore for three to four days, and some people may feel mild chest pressure or pain from where the heart tissue was treated. During this period, rest and limited physical activity is important.
“You can’t lift anything heavier than five pounds for five days,” Dominic says.
Even with these short-term effects, most patients experience a smooth recovery.
“In the long run, they actually feel better,” Dominic says. “If they can stop taking medication, many say they feel much better than they did before.”
A physicians perspective on VT ablation
VT ablation used to be seen as a last-resort treatment—something doctors would only try after everything else failed. But that thinking has changed.
“If a person keeps having VT and tries one medication after another, the ongoing VT can actually cause more scarring in the heart,” Dominic says. “That scarring makes future VT episodes more likely and makes ablation harder. By the time we do the ablation, the heart muscle can be so damaged that the patient can’t handle the procedure.”
A major study published in 2024 in the New England Journal of Medicine helped shift this thinking. The study looked at patients who didn’t respond to their first medication. Half were given a second drug, and the other half had a VT ablation. The results showed that the patients who had the ablation did better than those who were given more medication.
Unlike medications, VT ablation treats the root of the problem.
“VT ablation is more curative—you’re going inside the heart and fixing the exact spot causing the issue,” Dominic says. “Antiarrhythmic drugs don’t fix the problem. They just change how the heart’s electrical signals behave.”
Medications also come with side effects. Some can cause tiredness, fatigue, and rarely could cause serious lung, live and thyroid side effects while others often make patients feel sick to their stomachs.
Like any medical procedure, VT ablation does come with risks. The most common side effects are bleeding or bruising in the groin area where the catheters are placed. These are usually minor. More serious side effects—like heart failure—can happen, especially if a patient’s heart is already weak.
“Very rare complications include things like a tear in the heart, stroke, or even death,” Dominic says. “But these are extremely rare.”
As for success rates, “About 60 to 80% of patients don’t have another VT episode after ablation—and that’s without needing more medication,” he says. “But results vary from one patient to another based on their underlying heart disease.”
Key considerations for patients thinking about VT ablation
Not everyone is a match for VT ablation. Dominic says a patient needs to meet three basic conditions:
• They’ve had sustained VT (the abnormal rhythm lasts long enough to be serious).
• They’re healthy enough to safely go under general anesthesia.
• They’ve tried at least one medication, but it didn’t work.
In short: You need to be sick enough to need the procedure but healthy enough to go through it safely.
When it comes to VT ablation, experience matters. It is a complex procedure that should be done at a medical center that performs a high volume of VT ablations. More experience often means better outcomes and safer care.
“You don’t want to go to a place that only does one or two of these a year,” Dominic says. “At UI Health Care, we do two to three complex VT ablations every week.”
When talking to your doctor, don’t be afraid to ask important questions about the risks, the medications involved, and how experienced the hospital and staff are with VT ablation.
“It’s not just about the doctor,” Dominic says. “It’s about the whole team—nurses, anesthesiologists, techs.”
Before the procedure, it’s important to work with your care team to get your heart as healthy as possible. This may mean adjusting medications, managing other health conditions, and preparing mentally and physically for recovery.
Your doctor will guide you through each step, but staying informed and involved in your care can make a big difference.