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Catheter ablation for ventricular tachyarrhythmia in patients with channelopathies

机译:导管消融治疗通道病患者室速性心律失常

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摘要

Drug treatment and/or implantable cardioverter defibrillator (ICD) implantation are the most widely accepted first-line therapies for channelopathic patients who have recurrent syncope, sustained ventricular tachycardia (VT), or documented ventricular fibrillation (VF), or are survivors of cardiac arrest. In recent years, there have been significant advances in mapping techniques and ablation technology, coupled with better understanding of the mechanisms of ventricular tachyarrhythmia in channelopathies. Catheter ablation has provided important insights into the role of the Purkinje network and the right ventricular outflow tract in the initiation and perpetuation of VT/VF, and has evolved as a promising treatment modality for ventricular tachyarrhythmia even in channelopathies. When patients are exposed to a high risk of sudden cardiac death or deterioration of their quality of life due to episodes of tachycardia and frequent ICD discharges, catheter ablation may be an effective treatment option to reduce the risk of sudden cardiac death and decrease the frequency of cardiac events. In this review, we summarize the current understanding of catheter ablation for VT/VF in patients with channelopathies including Brugada syndrome, idiopathic VF, long QT syndrome, and catecholaminergic polymorphic VT.
机译:药物治疗和/或植入式心脏复律除颤器(ICD)植入是复发性晕厥,持续性室性心动过速(VT)或有记录的室性纤颤(VF)或心脏骤停幸存者的多发性病变患者最广泛接受的一线疗法。近年来,在制图技术和消融技术上取得了重大进展,并且加深了对通道病性室速心律失常机制的认识。导管消融术对Purkinje网络和右室流出道在VT / VF的形成和持续中的作用提供了重要的见识,并且已发展成为一种治疗室速性心律失常的有前途的治疗方式,即使在通道病变中也是如此。当患者因心动过速发作和频繁的ICD放电而面临心脏猝死或生活质量下降的高风险时,导管消融可能是一种有效的治疗选择,可降低心脏猝死的风险并降低发生心律失常的频率。心脏事件。在这篇综述中,我们总结了目前对患有包括Brugada综合征,特发性VF,长QT综合征和儿茶酚胺能性多形性VT在内的通道病患者的VT / VF消融的最新了解。

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