Department of Cardiovascular Medicine, Flinders Medical Centre, Cardiovascular Research Centre, Department of Cardiology, Royal Adelaide Hospital and the Discipline of Physiology, School of Molecular and Biomedical Science, University of Adelaide and School of Medicine, Flinders University, Adelaide, South Australia, Australia.
Intern Med J. 2010 Oct;40(10):673-81. doi: 10.1111/j.1445-5994.2010.02202.x.
Sudden cardiac death due to ventricular arrhythmias remains the most common cause of death in developed nations. Implantable cardioverter defibrillators have been shown to improve mortality in high-risk groups for ventricular tachyarrhythmias, but they are not curative, with the risk of arrhythmia recurrence remaining unaltered. It is also important to remember that ventricular tachycardia (VT) in the setting of a structurally normal heart is often not associated with an increased risk of sudden death and catheter ablation is a potentially curative procedure in this cohort. Recent advances in catheter ablation for VT have increased the efficacy in creating adequate lesions, accurate three-dimensional maps and mapping haemodynamically unstable VT, all of which have increased the utility of this modality in the treatment of ventricular arrhythmias. In this article, we review the recent advances that have fuelled renewed interest in catheter ablation of VT, its clinical utility and who should be referred.
由于室性心律失常导致的心脏性猝死仍然是发达国家最常见的死亡原因。植入式心脏复律除颤器已被证明可降低室性心动过速/室性心律失常高危人群的死亡率，但不能根治，心律失常复发的风险仍然存在。此外，还需注意，结构正常的心脏发生室性心动过速（VT）通常不会增加猝死的风险，导管消融是这部分患者潜在的根治性治疗手段。最近在导管消融治疗 VT 方面的进展提高了创建充分消融灶、精确的三维图谱和标测不稳定血流动力学 VT 的能力，所有这些都提高了该方法在治疗室性心律失常中的作用。本文将对 VT 导管消融治疗的最新进展、临床应用以及哪些患者应接受导管消融治疗进行综述。
