Background: Ventricular tachycardia (VT) is a life-threatening arrhythmia associated with sudden cardiac death, recurrent hospitalization, and implantable cardioverter-defibrillator shocks. Catheter ablation has emerged as an important therapeutic strategy for drug-refractory VT and recurrent ICD therapy.

Objective: To evaluate procedural success, recurrence rates, complications, and predictors of outcome following catheter-based treatment of VT.

Methods: A prospective observational study was conducted among 214 patients undergoing catheter ablation for sustained monomorphic VT between January 2022 and December 2024. Clinical characteristics, substrate type, mapping strategy, ablation approach, acute success, complications, and 12-month outcomes were analyzed.

Results: Ischemic cardiomyopathy was present in 58.4%, non-ischemic cardiomyopathy in 28.5%, and idiopathic VT in 13.1%. Acute procedural success was achieved in 82.7%. VT recurrence occurred in 24.8% during 12-month follow-up. Major complications occurred in 5.1%. Independent predictors of recurrence included LVEF <35%, non-ischemic substrate, multiple inducible VT morphologies, and incomplete substrate modification.

Conclusion: Catheter-based treatment of VT is effective and reasonably safe in contemporary electrophysiology practice. Outcomes are best in idiopathic VT and ischemic scar-related VT with complete substrate modification. Advanced structural heart disease remains associated with higher recurrence risk.