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07.09.2017 | Ventrikuläre Tachykardien | Übersichten

Aktuelles Management der Therapie ventrikulärer Tachykardien durch Katheterablation

Eine Übersicht

verfasst von: S. Koenig, A. Arya, G. Hindricks, B. Dinov

Erschienen in: Herz | Ausgabe 7/2018

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Zusammenfassung

Die Therapie ventrikulärer Tachykardien unterlag innerhalb der letzten Jahre einem relevanten Wandel. Interventionelle Strategien mittels Katheterablation gewinnen zunehmend an Bedeutung. Verschiedene aktuelle Studien demonstrierten einen Vorteil der Ablationsbehandlung gegenüber der konventionellen medikamentösen Behandlung. Die Identifizierung der effektivsten Techniken sowie der Patientenkollektive, welche am meisten von einem derartigen Eingriff profitieren, ist jedoch weiter Gegenstand aktueller Forschung. Die Vielzahl möglicher Formen und zugrunde liegender Entitäten von ventrikulären Tachykardien und die damit verbundene Notwendigkeit der Kenntnis aktueller Daten zur korrekten Indikationsstellung der Katheterablation stellen entsprechende Herausforderungen an den behandelnden Kardiologen dar. Die vorliegende Übersichtsarbeit fasst die aktuelle Studienlage in prägnanter Form zusammen.

Connolly SJ et al (2000) Canadian implantable defibrillator study (CIDS) : a randomized trial of the implantable cardioverter defibrillator against amiodarone. Circulation 101(11):1297–1302CrossRef

Epstein AE et al (2008) ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation 117(21):e350–408PubMed

Kuck KH et al (2000) Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest : the Cardiac Arrest Study Hamburg (CASH). Circulation 102(7):748–754CrossRef

Aliot EM et al (2009) EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias: developed in a partnership with the European Heart Rhythm Association (EHRA), a Registered Branch of the European Society of Cardiology (ESC), and the Heart Rhythm Society (HRS); in collaboration with the American College of Cardiology (ACC) and the American Heart Association (AHA). Heart Rhythm 6(6):886–933CrossRef

Priori SG et al (2015) 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC)Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Europace 17(11):1601–1687PubMed

Aldhoon B et al (2017) Outcomes of ventricular tachycardia ablation in patients with structural heart disease: The impact of electrical storm. PLOS ONE 12(2):e171830CrossRef

Prystowsky EN et al (2012) Ventricular arrhythmias in the absence of structural heart disease. J Am Coll Cardiol 59(20):1733–1744CrossRef

Vereckei A et al (2007) Application of a new algorithm in the differential diagnosis of wide QRS complex tachycardia. Eur Heart J 28(5):589–600CrossRef

Marine JE (2016) Nonsustained ventricular tachycardia in the normal heart: risk stratification and management. Card Electrophysiol Clin 8(3):525–543CrossRef

10.

Nogami A (2002) Idiopathic left ventricular tachycardia: assessment and treatment. Card Electrophysiol Rev 6(4):448–457CrossRef

11.

Tada H et al (2005) Idiopathic ventricular arrhythmia arising from the mitral annulus: a distinct subgroup of idiopathic ventricular arrhythmias. J Am Coll Cardiol 45(6):877–886CrossRef

12.

Tada H et al (2005) Idiopathic premature ventricular contractions arising from the pulmonary artery: importance of mapping in the pulmonary artery in left bundle branch block-shaped ventricular arrhythmias. Circ J 69(7):865–869CrossRef

13.

Tada H et al (2007) Idiopathic ventricular arrhythmias originating from the tricuspid annulus: Prevalence, electrocardiographic characteristics, and results of radiofrequency catheter ablation. Heart Rhythm 4(1):7–16CrossRef

14.

Yamada T et al (2009) Idiopathic focal ventricular arrhythmias originating from the anterior papillary muscle in the left ventricle. J Cardiovasc Electrophysiol 20(8):866–872CrossRef

15.

Hingorani P et al (2016) Arrhythmias seen in baseline 24-hour Holter ECG recordings in healthy normal volunteers during phase 1 clinical trials. J Clin Pharmacol 56(7):885–893CrossRef

16.

Kim RJ et al (2007) Clinical and electrophysiological spectrum of idiopathic ventricular outflow tract arrhythmias. J Am Coll Cardiol 49(20):2035–2043CrossRef

17.

Krittayaphong R et al (2002) Effect of atenolol on symptomatic ventricular arrhythmia without structural heart disease: a randomized placebo-controlled study. Am Heart J 144(6):e10CrossRef

18.

Aquaro GD et al (2010) Cardiac magnetic resonance predicts outcome in patients with premature ventricular complexes of left bundle branch block morphology. J Am Coll Cardiol 56(15):1235–1243CrossRef

19.

Hoffmayer KS et al (2013) An electrocardiographic scoring system for distinguishing right ventricular outflow tract arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy from idiopathic ventricular tachycardia. Heart Rhythm 10(4):477–482CrossRef

20.

Novak J et al (2016) Electrocardiographic differentiation of idiopathic right ventricular outflow tract ectopy from early arrhythmogenic right ventricular cardiomyopathy. Europace. https://doi.org/10.1093/europace/euw018 CrossRefPubMedPubMedCentral

21.

Marine JE et al (2013) Prevalence and prognostic significance of exercise-induced nonsustained ventricular tachycardia in asymptomatic volunteers: BLSA (Baltimore Longitudinal Study of Aging). J Am Coll Cardiol 62(7):595–600CrossRef

22.

Seth N et al (2015) Clinical significance of nonsustained ventricular tachycardia on routine monitoring of pacemaker patients. Pacing Clin Electrophysiol 38(8):980–988CrossRef

23.

Noda T et al (2005) Malignant entity of idiopathic ventricular fibrillation and polymorphic ventricular tachycardia initiated by premature extrasystoles originating from the right ventricular outflow tract. J Am Coll Cardiol 46(7):1288–1294CrossRef

24.

Viskin S et al (2005) The „short-coupled“ variant of right ventricular outflow ventricular tachycardia: a not-so-benign form of benign ventricular tachycardia? J Cardiovasc Electrophysiol 16(8):912–916CrossRef

25.

Ichikawa T et al (2016) Beat-to-beat T‑wave amplitude variability in the risk stratification of right ventricular outflow tract-premature ventricular complex patients. Europace 18(1):138–145CrossRef

26.

Moss JD, Tung R (2016) Sustained ventricular tachycardia in apparently normal hearts: ablation should be the first step in management. Card Electrophysiol Clin 8(3):623–630CrossRef

27.

Baman TS et al (2010) Relationship between burden of premature ventricular complexes and left ventricular function. Heart Rhythm 7(7):865–869CrossRef

28.

Hasdemir C et al (2011) Tachycardia-induced cardiomyopathy in patients with idiopathic ventricular arrhythmias: the incidence, clinical and electrophysiologic characteristics, and the predictors. J Cardiovasc Electrophysiol 22(6):663–668CrossRef

29.

Takemoto M et al (2005) Radiofrequency catheter ablation of premature ventricular complexes from right ventricular outflow tract improves left ventricular dilation and clinical status in patients without structural heart disease. J Am Coll Cardiol 45(8):1259–1265CrossRef

30.

Bogun F et al (2007) Radiofrequency ablation of frequent, idiopathic premature ventricular complexes: comparison with a control group without intervention. Heart Rhythm 4(7):863–867CrossRef

31.

Marchlinski FE et al (2016) Long-term success of irrigated radiofrequency catheter ablation of sustained ventricular tachycardia: post-approval THERMOCOOL VT trial. J Am Coll Cardiol 67(6):674–683CrossRef

32.

Tanner H et al (2010) Catheter ablation of recurrent scar-related ventricular tachycardia using electroanatomical mapping and irrigated ablation technology: results of the prospective multicenter Euro-VT-study. J Cardiovasc Electrophysiol 21(1):47–53CrossRef

33.

Poole JE et al (2008) Prognostic importance of defibrillator shocks in patients with heart failure. N Engl J Med 359(10):1009–1017CrossRef

34.

Frontera A et al (2016) Safety and mid-term outcome of catheter ablation of ventricular tachycardia in octogenarians. Europace. https://doi.org/10.1093/europace/euw236 CrossRefPubMed

35.

Halbfass P et al (2017) Catheter ablation of ventricular extrasystoles and ventricular tachycardia in the elderly. Herzschrittmacherther Elektrophysiol. https://doi.org/10.1007/s00399-017-0483-5 CrossRef

36.

Tzou WS et al (2017) Ventricular tachycardia ablation in severe heart failure: an international ventricular tachycardia ablation center collaboration analysis. Circ Arrhythm Electrophysiol. https://doi.org/10.1161/CIRCEP.116.004494

37.

Kumar S et al (2017) Beyond the storm: comparison of clinical factors, arrhythmogenic substrate, and catheter ablation outcomes in structural heart disease patients with versus those without a history of ventricular tachycardia storm. J Cardiovasc Electrophysiol 28(1):56–67CrossRef

38.

Raymond JM et al (2009) Catheter ablation for scar-related ventricular tachycardias. Curr Probl Cardiol 34(5):225–270CrossRef

39.

Acosta J et al (2016) Elucidation of hidden slow conduction by double ventricular extrastimuli: a method for further arrhythmic substrate identification in ventricular tachycardia ablation procedures. Europace. https://doi.org/10.1093/europace/euw325 CrossRef

40.

Acosta J et al (2017) Multielectrode vs. point-by-point mapping for ventricular tachycardia substrate ablation: a randomized study. Europace. https://doi.org/10.1093/europace/euw406 CrossRefPubMed

41.

Kumar S et al (2016) Substrate-based ablation versus ablation guided by activation and entrainment mapping for ventricular tachycardia: a systematic review and meta-analysis. J Cardiovasc Electrophysiol 27(12):1437–1447CrossRef

42.

Gokoglan Y et al (2016) Scar homogenization versus limited-substrate ablation in patients with nonischemic cardiomyopathy and ventricular tachycardia. J Am Coll Cardiol 68(18):1990–1998CrossRef

43.

Pascale P et al (2009) Ventricular arrhythmia in coronary artery disease: limits of a risk stratification strategy based on the ejection fraction alone and impact of infarct localization. Europace 11(12):1639–1646CrossRef

44.

Harkness JR et al (2011) Myocardial ischemia and ventricular tachycardia on continuous electrocardiographic monitoring and risk of cardiovascular outcomes after non-ST-segment elevation acute coronary syndrome (from the MERLIN-TIMI 36 Trial). Am J Cardiol 108(10):1373–1381CrossRef

45.

Orvin K et al (2016) Outcome of contemporary acute coronary syndrome complicated by ventricular tachyarrhythmias. Europace 18(2):219–226CrossRef

46.

Di Marco A et al (2016) Chronic total occlusion of an infarct-related artery: a new predictor of ventricular arrhythmias in primary prevention implantable cardioverter defibrillator patients. Europace. https://doi.org/10.1093/europace/euw009 CrossRefPubMed

47.

Patel D et al (2016) Catheter ablation for ventricular tachycardia (VT) in patients with ischemic heart disease: a systematic review and a meta-analysis of randomized controlled trials. J Interv Card Electrophysiol 45(2):111–117CrossRef

48.

Santangeli P et al (2016) Comparative effectiveness of antiarrhythmic drugs and catheter ablation for the prevention of recurrent ventricular tachycardia in patients with implantable cardioverter-defibrillators: A systematic review and meta-analysis of randomized controlled trials. Heart Rhythm 13(7):1552–1559CrossRef

49.

Sapp JL et al (2016) Ventricular tachycardia ablation versus escalation of antiarrhythmic drugs. N Engl J Med 375(2):111–121CrossRef

50.

51.

Della Bella P et al (2004) Incidence and significance of pleomorphism in patients with postmyocardial infarction ventricular tachycardia. Acute and long-term outcome of radiofrequency catheter ablation. Eur Heart J 25(13):1127–1138CrossRef

52.

Hadid C et al (2011) Incidence, determinants, and prognostic implications of true pleomorphism of ventricular tachycardia in patients with implantable cardioverter-defribillators: a substudy of the DATAS Trial. Circ Arrhythm Electrophysiol 4(1):33–42CrossRef

53.

Liu E, Josephson ME (2011) Pleomorphic ventricular tachycardia and risk for sudden cardiac death. Circ Arrhythm Electrophysiol 4(1):2–4CrossRef

54.

Skoda J et al (2016) Catheter ablation of Ischemic ventricular tachycardia with remote magnetic navigation: STOP-VT Multicenter trial. J Cardiovasc Electrophysiol 27(Suppl 1):S29–37CrossRef

55.

Kuck KH et al (2010) Catheter ablation of stable ventricular tachycardia before defibrillator implantation in patients with coronary heart disease (VTACH): a multicentre randomised controlled trial. Lancet 375(9708):31–40CrossRef

56.

Dinov B et al (2014) Outcomes in catheter ablation of ventricular tachycardia in dilated nonischemic cardiomyopathy compared with ischemic cardiomyopathy: results from the Prospective Heart Centre of Leipzig VT (HELP-VT) Study. Circulation 129(7):728–736CrossRef

57.

Kumar S et al (2016) Long-term outcomes after catheter ablation of ventricular tachycardia in patients with and without structural heart disease. Heart Rhythm 13(10):1957–1963CrossRef

58.

Muser D et al (2016) Long-term outcome after catheter ablation of ventricular tachycardia in patients with Nonischemic dilated Cardiomyopathy. Circ Arrhythm Electrophysiol 9(10):e4328CrossRef

59.

Souissi Z et al (2016) Catheter ablation reduces ventricular tachycardia burden in patients with arrhythmogenic right ventricular cardiomyopathy: insights from a north-western French multicentre registry. Europace. https://doi.org/10.1093/europace/euw332 CrossRef

60.

Berruezo A et al (2016) Safety, long-term outcomes and predictors of recurrence after first-line combined endoepicardial ventricular tachycardia substrate ablation in arrhythmogenic cardiomyopathy. Impact of arrhythmic substrate distribution pattern. A prospective multicentre study. Europace. https://doi.org/10.1093/europace/euw212 CrossRefPubMed

61.

Berte B et al (2016) A new cryoenergy for ventricular tachycardia ablation: a proof-of-concept study. Europace. https://doi.org/10.1093/europace/euw217 CrossRefPubMed

62.

Tschabrunn CM et al (2016) A swine model of infarct-related reentrant ventricular tachycardia: Electroanatomic, magnetic resonance, and histopathological characterization. Heart Rhythm 13(1):262–273CrossRef

Titel: Aktuelles Management der Therapie ventrikulärer Tachykardien durch Katheterablation
Eine Übersicht
verfasst von: S. Koenig
A. Arya
G. Hindricks
B. Dinov
Publikationsdatum: 07.09.2017
Verlag: Springer Medizin
Schlagwort: Ventrikuläre Tachykardien
Erschienen in: Herz / Ausgabe 7/2018
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-017-4615-9

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