Strategies for catheter ablation of scar-related ventricular tachycardia

被引：17

作者：

Stevenson W.G. ^{[1
]}

Delacretaz E. ^{[1
]}

机构：

[1] Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115

来源：

Current Cardiology Reports | 2000年 / 2卷 / 6期

关键词：

Ventricular Tachycardia; Cardiac Sarcoidosis; Arrhythmogenic Right Ventricular Dysplasia; Nonischemic Cardiomyopathy; Inducible Ventricular Tachycardia;

D O I：

10.1007/s11886-000-0039-9

中图分类号：

学科分类号：

摘要：

Ventricular tachycardia (VT) due to reentry in and around regions of ventricular scar from an old myocardial infarction or cardiomyopathic process is often a difficult management problem. Radiofrequency catheter ablation is an option for controlling frequent VT episodes. Patient and VT characteristics determine the mapping and ablation approach and efficacy. In patients with a VT that is hemodynamically tolerated to allow mapping, prevention of recurrent VT is achieved in 54% to 66% of patients with a procedure related mortality of 1% to 2.7%. Multiple morphologies of monomorphic VT and circuits that are located deep to the endocardium are common problems that reduce efficacy. Mapping to identify target regions for ablation can be difficult if VT is rapid and not tolerated, or not inducible. Ablation of these "unmappable VTs" by designing ablation lines or areas based on the characteristics of the scar as assessed during sinus rhythm, and using approaches to assess global activation from a limited number of beats has been shown to be feasible. Ablation of multiple VTs, epicardial VTs, and poorly tolerated VTs are feasible. Future studies defining efficacy and risks are needed. Copyright © 2000 by Current Science Inc.

引用

页码：537 / 544

页数：7

共 41 条

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