Spartalis Michael, Spartalis Eleftherios, Tzatzaki Eleni, Tsilimigras Diamantis I, Moris Demetrios, Kontogiannis Christos, Livanis Efthimios, Iliopoulos Dimitrios C, Voudris Vassilis, Theodorakis George N
ESC Working Group on Cardiac Cellular Electrophysiology, Sophia Antipolis Cedex 06903, France.
Laboratory of Experimental Surgery and Surgical Research, University of Athens Medical School, Athens 11527, Greece.
World J Cardiol. 2018 Jul 26;10(7):52-59. doi: 10.4330/wjc.v10.i7.52.
Ventricular tachycardia (VT) is a crucial cause of sudden cardiac death (SCD) and a primary cause of mortality and morbidity in patients with structural cardiac disease. VT includes clinical disorders varying from benign to life-threatening. Most life-threatening episodes are correlated with coronary artery disease, but the risk of SCD varies in certain populations, with various underlying heart conditions, specific family history, and genetic variants. The targets of VT management are symptom alleviation, improved quality of life, reduced implantable cardioverter defibrillator shocks, prevention of reduction of left ventricular function, reduced risk of SCD, and improved overall survival. Antiarrhythmic drug therapy and endocardial catheter ablation remains the cornerstone of guideline-endorsed VT treatment strategies in patients with structural cardiac abnormalities. Novel strategies such as epicardial ablation, surgical cryoablation, transcoronary alcohol ablation, pre-procedural imaging, and stereotactic ablative radiotherapy are an appealing area of research. In this review, we gathered all recent advances in innovative therapies as well as experimental evidence focusing on different aspects of VT treatment that could be significant for future favorable clinical applications.
室性心动过速（VT）是心源性猝死（SCD）的关键原因，也是结构性心脏病患者死亡和发病的主要原因。VT包括从良性到危及生命的各种临床病症。大多数危及生命的发作与冠状动脉疾病相关，但SCD的风险在某些人群中有所不同，这些人群存在各种潜在的心脏疾病、特定的家族病史和基因变异。VT治疗的目标是缓解症状、提高生活质量、减少植入式心脏复律除颤器电击次数、预防左心室功能减退、降低SCD风险并提高总体生存率。抗心律失常药物治疗和心内膜导管消融仍然是结构性心脏异常患者指南认可的VT治疗策略的基石。诸如心外膜消融、手术冷冻消融、经冠状动脉酒精消融、术前成像和立体定向消融放疗等新策略是一个有吸引力的研究领域。在本综述中，我们收集了创新疗法的所有最新进展以及聚焦于VT治疗不同方面的实验证据，这些证据可能对未来良好的临床应用具有重要意义。
