Contemporary management of ventricular arrhythmias in heart failure.

IF 1.3 American journal of cardiovascular disease Pub Date : 2023-08-15 eCollection Date: 2023-01-01

Ourania Kariki, Maximos Georgopoulos, Nikitas Katsillis, Anastasios Chatziantoniou, Stavroula Koskina, Andromahi Zygouri, Athanasios Saplaouras, George Bazoukis, Aggeliki Gkouziouta, Konstantinos Vlachos, Stylianos Dragasis, Panagiotis Mililis, Stamatis Adamopoulos, Michael Efremidis, Konstantinos P Letsas

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Abstract

Enhanced ventricular arrhythmogenesis is commonly experienced by patients in the end-stage of heart failure spectrum. A high burden of ventricular arrhythmias can affect the ventricular systolic function, lead to unexpected hospitalizations and further deteriorate the prognosis. Management of ventricular arrhythmias in this population is challenging. Implantable cardioverter-defibrillators are protective for the immediate termination of life-threatening arrhythmias but they have no impact in reducing the arrhythmic burden. Combination treatment with invasive (catheter ablation, mechanical hemodynamic support, sympathetic denervation) and noninvasive (antiarrhythmic drugs, medical therapy for heart failure, programming of implantable devices) therapies is commonly required. The aim of this review is to present the available therapeutic options, with main focus on recently published data for catheter ablation and provide a stepwise treatment approach.

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心力衰竭室性心律失常的现代治疗。

心力衰竭终末期患者通常会经历室性心律失常发生增强。高负荷的室性心律失常会影响心室收缩功能，导致意外住院，并进一步恶化预后。在这一人群中，室性心律失常的治疗具有挑战性。植入式心律转复除颤器可立即终止危及生命的心律失常，但对减少心律失常负担没有影响。通常需要有创（导管消融、机械血液动力学支持、交感神经去神经支配）和无创（抗心律失常药物、心力衰竭药物治疗、植入式设备编程）疗法的联合治疗。本综述的目的是介绍可用的治疗方案，主要关注最近发表的导管消融数据，并提供一种分步治疗方法。

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American journal of cardiovascular disease CARDIAC & CARDIOVASCULAR SYSTEMS-

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