Thompson Nathaniel, Frontera Antonio, Takigawa Masateru, Cheniti Ghassen, Massoullie Gregoire, Cochet Hubert, Denis Arnaud, Chaumeil Arnaud, Derval Nicolas, Hocini Meleze, Haissaguerre Michel, Jais Pierre, Sacher Frederic
Bordeaux University Hospital, LIRYC Institute, INSERM 1045, Bordeaux University, France.
Bordeaux University Hospital, LIRYC Institute, INSERM 1045, Bordeaux University, France.
Card Electrophysiol Clin. 2017 Mar;9(1):47-54. doi: 10.1016/j.ccep.2016.10.003. Epub 2016 Dec 24.
Although catheter ablation has been successful in reducing the recurrence of ventricular tachycardia in patients with ischemic disease, outcomes in patients with nonischemic cardiomyopathy (NICM) have not met with the same results. Success is predicated on a methodical approach to diagnosis of disease type and identification of critical substrate, and the ablation strategies used. Cardiac MRI with delayed enhancement is able to identify areas of substrate involvement, particularly in situations when conventional catheter mapping is not able to do so. Radiofrequency needle, irrigated bipolar radiofrequency, and transcoronary alcohol ablation are effective and alternative techniques to endocardial and epicardial ablation.
尽管导管消融术已成功降低了缺血性疾病患者室性心动过速的复发率，但非缺血性心肌病（NICM）患者的治疗结果却不尽相同。成功取决于对疾病类型诊断和关键基质识别的系统方法，以及所采用的消融策略。延迟强化心脏磁共振成像能够识别基质受累区域，特别是在传统导管标测无法做到这一点的情况下。射频针、灌注射频和经冠状动脉酒精消融是心内膜和心外膜消融的有效替代技术。
