[Long-term results of catheter ablation of idiopathic and structural ventricular tachycardia].
Langzeitergebnisse der Katheterablation idiopathischer und struktureller Kammertachykardien.
Idiopathic ventricular arrhythmias
Preprocedural imaging
Quality of life
Randomized trials
Ventricular tachycardia
Journal
Herzschrittmachertherapie & Elektrophysiologie
ISSN: 1435-1544
Titre abrégé: Herzschrittmacherther Elektrophysiol
Pays: Germany
ID NLM: 9425873
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
19
07
2023
accepted:
20
09
2023
medline:
28
11
2023
pubmed:
19
10
2023
entrez:
19
10
2023
Statut:
ppublish
Résumé
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. Die Katheterablation von Kammertachykardien hat sich in den letzten Jahren durch zunehmende Erfahrung und technologische Fortschritte zu einer effektiven Behandlungsmodalität entwickelt. Die Katheterablation idiopathischer Kammertachykardien ist auch im Langzeitverlauf in Abhängigkeit der anatomischen Zielregion teils hocheffektiv und daher in bestimmten Fällen als Erstlinientherapie in den aktuellen Leitlinien der Fachgesellschaften verankert. Die Katheterablation bei Patienten mit Kammertachykardien und struktureller Herzerkrankung hat deutlich eingeschränkte Erfolgsaussichten. Die Katheterablation bei Patienten mit ischämischer Kardiomyopathie ist in mehreren randomisierten multizentrischen Studien evaluiert. Bei diesen Patienten konnte eine signifikant höhere Effektivität zur Reduktion von Arrhythmierezidiven durch die Ablation im Vergleich zu konservativen Behandlungen nachgewiesen werden. Die Katheterablation bei Patienten mit nichtischämischer Kardiomyopathie ist insbesondere im Langzeitverlauf mit hohen Rezidivraten vergesellschaftet. Der sichere Nachweis eines Mortalitätsbenefits durch die Katheterablation konnte bislang nicht erbracht werden. Die Ablation kann somit auch nur in Ausnahmefällen als Alternative zur Implantation eines Kardioverter-Defibrillators (ICD) gesehen werden.
Autres résumés
Type: Publisher
(ger)
Die Katheterablation von Kammertachykardien hat sich in den letzten Jahren durch zunehmende Erfahrung und technologische Fortschritte zu einer effektiven Behandlungsmodalität entwickelt. Die Katheterablation idiopathischer Kammertachykardien ist auch im Langzeitverlauf in Abhängigkeit der anatomischen Zielregion teils hocheffektiv und daher in bestimmten Fällen als Erstlinientherapie in den aktuellen Leitlinien der Fachgesellschaften verankert. Die Katheterablation bei Patienten mit Kammertachykardien und struktureller Herzerkrankung hat deutlich eingeschränkte Erfolgsaussichten. Die Katheterablation bei Patienten mit ischämischer Kardiomyopathie ist in mehreren randomisierten multizentrischen Studien evaluiert. Bei diesen Patienten konnte eine signifikant höhere Effektivität zur Reduktion von Arrhythmierezidiven durch die Ablation im Vergleich zu konservativen Behandlungen nachgewiesen werden. Die Katheterablation bei Patienten mit nichtischämischer Kardiomyopathie ist insbesondere im Langzeitverlauf mit hohen Rezidivraten vergesellschaftet. Der sichere Nachweis eines Mortalitätsbenefits durch die Katheterablation konnte bislang nicht erbracht werden. Die Ablation kann somit auch nur in Ausnahmefällen als Alternative zur Implantation eines Kardioverter-Defibrillators (ICD) gesehen werden.
Identifiants
pubmed: 37855890
doi: 10.1007/s00399-023-00964-1
pii: 10.1007/s00399-023-00964-1
doi:
Types de publication
English Abstract
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM
Pagination
298-304Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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