Colella A, Pieragnoli P, Ricciardi G, Giaccardi M, Padeletti L, Michelucci A
Department of Heart and Vessels, University of Florence, Florence, Italy.
Minerva Cardioangiol. 2007 Jun;55(3):341-51.
The aim of this article is to report the evidences about the use of drugs and ablation after implantation of a cardioverter defibrillator. Drugs can be utilized to prevent appropriate and inappropriate shocks, can influence positively or negatively defibrillation threshold, can be useful for the treatment of electrical storm. Ablation can be performed for direct cure of coexisting atrial and ventricular tachyarrhythmias or for AV node modulation. In particular, previous data demonstrate that rescue ventricular tachycardia ablation of drug-refractory electrical storm is possible by a substrate-orientated ablation approach even in patients with complex chronic infarction and various ventricular tachycardias. At the end of this article it is described how remote monitoring, a new very promising technical improvement, can be utilized for deciding, almost in real time, the use of both these therapies or for controlling their efficacy.
本文旨在报告有关植入心脏复律除颤器后使用药物和消融治疗的证据。药物可用于预防恰当和不恰当的电击，可对除颤阈值产生正向或负向影响，可用于治疗电风暴。消融可用于直接治愈并存的房性和室性快速性心律失常或用于房室结调制。特别是，先前的数据表明，即使在患有复杂慢性梗死和各种室性心动过速的患者中，采用基于基质的消融方法对药物难治性电风暴进行抢救性室性心动过速消融也是可行的。本文结尾描述了远程监测这一非常有前景的新的技术改进如何能够几乎实时地用于决定这两种治疗方法的使用或用于控制它们的疗效。
