Decompensated Heart Failure With Ventricular Arrhythmia: How Useful Is VT Ablation?

被引：2
作者：
Dimitropoulos G. [1 ]
Leventogiannis G. [1 ]
De Bono J. [1 ]
机构：
[1] Cardiology Department, University Hospital Birmingham, Birmingham
来源：
Current Heart Failure Reports | 2018年 / 15卷 / 4期
关键词：
Amiodarone; Catheter ablation; Electrical storm; Heart failure; Structural heart disease; Ventricular tachycardia;
D O I：
10.1007/s11897-018-0395-7
中图分类号：
学科分类号：
摘要：
Purpose of Review: Ventricular arrhythmias are common in patients with heart failure. Their management especially in the context of decompensated heart failure poses a clinical challenge to modern cardiologists. In this review article, we aim to summarise the current evidence on the epidemiology, pathophysiology, and management of ventricular tachycardia in heart failure, focusing primarily on the use of catheter ablation. Recent Findings: The evolution of electro-anatomical mapping techniques and ablation catheter technology in the recent years has paved the path for the successful application of catheter ablation in the treatment of ventricular arrhythmias. The efficacy of catheter ablation in the management of ventricular tachycardia in patients with chronic heart failure has recently been the epicentre of a number of randomised controlled trials, demonstrating promising results with regard to arrhythmia suppression and all-cause mortality. The usefulness of catheter ablation in decompensated heart failure has been explored to a lesser degree, primarily in the setting of an electrical storm. Summary: Implantable cardiac defibrillators play the most important role in improving prognosis and preventing sudden cardiac death in patients with heart failure. Catheter ablation for the treatment of recurrent VT in patients with chronic heart failure is an efficacious strategy that can be applied adjunctively to or in instead of antiarrhythmic therapy, and it is highly successful at preventing recurrent ventricular tachycardia, ICD shocks. Its efficacy in the context of decompensated heart failure requires further research, with current evidence rendering its use promising. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
引用
收藏
页码：201 / 213
页数：12
相关论文
共 99 条
[1]  
Ponikowski P., Voors A.A., Anker S.D., Bueno H., Cleland J.G., Coats A.J., Et al., 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC, Eur J Heart Fail, 18, 8, pp. 891-975, (2016)
[2]  
Yancy C.W., Jessup M., Bozkurt B., Butler J., Casey D.E., Drazner M.H., Et al., 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, J Am Coll Cardiol, 62, 16, pp. e147-e239, (2013)
[3]  
Connolly S.J., Gent M., Roberts R.S., Dorian P., Roy D., Sheldon R.S., Et al., Canadian implantable defibrillator study (CIDS): a randomized trial of the implantable cardioverter defibrillator against amiodarone, Circulation, 101, 11, pp. 1297-1302, (2000)
[4]  
Kuck K.H., Cappato R., Siebels J., Ruppel R., Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest: the Cardiac Arrest Study Hamburg (CASH), Circulation, 102, 7, pp. 748-754, (2000)
[5]  
Raitt M.H., Renfroe E.G., Epstein A.E., McAnulty J.H., Mounsey P., Steinberg J.S., Et al., Stable” ventricular tachycardia is not a benign rhythm: insights from the antiarrhythmics versus implantable defibrillators (AVID) registry, Circulation, 103, 2, pp. 244-252, (2001)
[6]  
Poole J.E., Johnson G.W., Hellkamp A.S., Anderson J., Callans D.J., Raitt M.H., Et al., Prognostic importance of defibrillator shocks in patients with heart failure, N Engl J Med, 359, 10, pp. 1009-1017, (2008)
[7]  
Sweeney M.O., Sherfesee L., DeGroot P.J., Wathen M.S., Wilkoff B.L., Differences in effects of electrical therapy type for ventricular arrhythmias on mortality in implantable cardioverter-defibrillator patients, Heart Rhythm, 7, 3, pp. 353-360, (2010)
[8]  
Moss A.J., Greenberg H., Case R.B., Zareba W., Hall W.J., Brown M.W., Et al., Long-term clinical course of patients after termination of ventricular tachyarrhythmia by an implanted defibrillator, Circulation, 110, 25, pp. 3760-3765, (2004)
[9]  
Sacher F., Tedrow U.B., Field M.E., Raymond J.M., Koplan B.A., Epstein L.M., Et al., Ventricular tachycardia ablation: evolution of patients and procedures over 8 years, Circ Arrhythm Electrophysiol, 1, 3, pp. 153-161, (2008)
[10]  
Lampert R., Wang Y., Curtis J.P., Variation among hospitals in selection of higher-cost, “higher-tech,” implantable cardioverter-defibrillators: data from the National Cardiovascular Data Registry (NCDR) Implantable Cardioverter/Defibrillator (ICD) Registry, Am Heart J, 165, 6, pp. 1015-1023, (2013)
12345678910