Okubo Kenji, Gigli Lorenzo, Della Bella Paolo
Arrhythmia Unit and Electrophysiology Laboratories Ospedale San Raffaele Milano Italy.
J Arrhythm. 2018 Aug 28;34(4):347-355. doi: 10.1002/joa3.12099. eCollection 2018 Aug.
The number of patients with nonischemic cardiomyopathy (NICM) undergoing catheter ablation of ventricular tachycardia (VT) has increased by the years, however, there are no randomized studies of VT ablation in this population. Many studies have reported more mixed or inferior outcome after the ablation in patients with NICM as compared to in those with ischemic cardiomyopathy (ICM)-likely because of the heterogeneous VT substrates in each etiology. While, various ablation strategies for substrate modification in the setting of ICM, including low voltage area ablation, late potential abolition, and local abnormal ventricular activity elimination, have been well established, it is still unknown which ablation strategy is effective for prevention of recurrence VTs in NICM patients. Therefore, this review will highlight the recent progress made in VT ablation in patients with NICM.
近年来，接受室性心动过速（VT）导管消融术的非缺血性心肌病（NICM）患者数量有所增加，然而，目前尚无针对该人群进行VT消融的随机研究。许多研究报告称，与缺血性心肌病（ICM）患者相比，NICM患者消融术后的结果更为复杂或较差，这可能是因为每种病因中的VT基质存在异质性。虽然，在ICM背景下，各种用于基质改良的消融策略，包括低电压区消融、晚期电位消除和局部异常心室活动消除，已经得到了很好的确立，但对于预防NICM患者VT复发哪种消融策略有效仍不清楚。因此，本综述将重点介绍NICM患者VT消融的最新进展。
