Fernández-Armenta Juan, Penela Diego, Acosta Juan, Andreu David, Berruezo Antonio
Arrhythmia Section, Cardiology Department, Puerta del Mar University Hospital, Cádiz, Spain.
Arrhythmia Section, Cardiology Department, Hospital Clínic and IDIBAPS (Institut d'Investigació Agustí Pi i Sunyer), Barcelona, Spain.
Card Electrophysiol Clin. 2015 Sep;7(3):527-37. doi: 10.1016/j.ccep.2015.05.011. Epub 2015 Jun 27.
Most patients with structural heart disease referred for ventricular tachycardia ablation have unstable tachycardias not suitable for conventional mapping (ie, entrainment mapping). Substrate-guided mapping and ablation during sinus rhythm are intended to overcome the limitations of conventional mapping and ablation. Substrate ablation permits elimination of multiple ventricular tachycardias irrespective of their inducibility during the procedure or their hemodynamic tolerability. Moreover, the elimination/isolation of the arrhythmogenic substrate identified during sinus rhythm has been associated with better outcomes. There is currently no standardized approach for substrate-guided ablation. This article discusses the main aspects of the proposed techniques and substrate ablation targets.
大多数因室性心动过速消融而转诊的结构性心脏病患者存在不稳定的心动过速，不适合传统标测（即拖带标测）。窦性心律期间的基质引导标测和消融旨在克服传统标测和消融的局限性。基质消融可消除多种室性心动过速，无论其在手术期间的可诱导性或血流动力学耐受性如何。此外，在窦性心律期间识别出的致心律失常基质的消除/隔离与更好的结果相关。目前尚无基质引导消融的标准化方法。本文讨论了所提出技术和基质消融靶点的主要方面。
