[特发性和结构性室性心动过速导管消融的长期结果]。

Q4 Medicine Herzschrittmachertherapie und Elektrophysiologie Pub Date : 2023-12-01 Epub Date: 2023-10-19 DOI:10.1007/s00399-023-00964-1
Philipp Lucas, Vanessa Sciacca, Philipp Sommer, Thomas Fink
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引用次数: 0

摘要

室性心动过速(VT)的导管消融已成为一种有效的治疗方式。特发性室性心动过速的消融程序取决于心律失常的解剖起源,在某些情况下非常有效,并且在最近的欧洲指南中已作为一线治疗方法实施。相反,结构性心脏病患者的导管消融术具有心律失常复发的显著风险。在多个随机多中心试验中研究了缺血性心肌病患者的介入治疗,结果表明,与保守治疗方式相比,导管消融在抑制心律失常方面更有效。几项长期研究表明,非缺血性心肌病的导管消融术心律失常复发率要高得多,通常需要复杂的心外膜标测和消融术。目前还没有明确的证据表明,导管消融术对患有或不患有结构性心脏病的患者的死亡率有好处。然而,最近的指南建议,在选定的病例中,导管消融是植入心律转复除颤器(ICD)的替代方案。
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[Long-term results of catheter ablation of idiopathic and structural ventricular tachycardia].

Catheter ablation of ventricular tachycardia (VTs) has emerged as an effective treatment modality. Ablation procedures for idiopathic VTs depends on the anatomical origin of the arrhythmias, is highly effective in certain cases, and has been implemented as a first-line therapy in recent European guidelines. In contrast, catheter ablation of VTs in patients with structural heart disease has a significant risk of arrhythmia recurrence. Interventional treatment for patients with ischemic cardiomyopathy was studied in multiple randomized multicenter trials and it was shown that catheter ablation was more effective in arrhythmia suppression compared to conservative treatment modalities. Catheter ablation of nonischemic cardiomyopathy suffers from far higher rates of arrhythmia recurrences as documented in several long-term studies and often needs complex procedures with or without epicardial mapping and ablation. There is still no clear proof of a mortality benefit from catheter ablation of VTs in patients with or without structural heart disease. Nevertheless, recent guidelines recommend catheter ablation as an alternative to implantation of cardioverter-defibrillators (ICD) in selected cases.

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来源期刊
Herzschrittmachertherapie und Elektrophysiologie
Herzschrittmachertherapie und Elektrophysiologie Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.10
自引率
0.00%
发文量
76
期刊介绍: Mit wissenschaftlichen Original- und Übersichtsarbeiten, Berichten über moderne Operationstechniken und experimentelle Methoden ist die Zeitschrift Herzschrittmachertherapie + Elektrophysiologie ein Diskussionsforum für Themen wie: - Zelluläre Elektrophysiologie - Theoretische Elektrophysiologie - Klinische Elektrophysiologie - Angewandte Herzschrittmachertherapie - Bradykarde und tachykarde Herzrhythmusstörungen - Plötzlicher Herztod und Risikostratifikation - Elektrokardiographie - Elektromedizinische Technologie - Experimentelle und klinische Pharmakologie - Herzchirurgie bei Herzrhythmusstörungen Mitteilungen der Arbeitsgruppen Herzschrittmacher und Arrhythmie der Deutschen Gesellschaft für Kardiologie - Herz und Kreislaufforschung e.V. (DGK) sowie Stellungnahmen und praktische Hinweise runden das breite Spektrum dieser Zeitschrift ab. Interessensgebiete: Kardiologie, Herzschrittmachertherapie, Herzschrittmachertechnologie, klinische Elektrophysiologie
期刊最新文献
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