Hartford Hospital, Hartford, Connecticut.
University of Michigan, Ann Arbor, Michigan.
Heart Rhythm. 2020 Jan;17(1):e155-e205. doi: 10.1016/j.hrthm.2019.03.014. Epub 2019 May 10.
Ventricular arrhythmias are an important cause of morbidity and mortality and come in a variety of forms, from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. Rapid developments have taken place over the past decade in our understanding of these arrhythmias and in our ability to diagnose and treat them. The field of catheter ablation has progressed with the development of new methods and tools, and with the publication of large clinical trials. Therefore, global cardiac electrophysiology professional societies undertook to outline recommendations and best practices for these procedures in a document that will update and replace the 2009 EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias. An expert writing group, after reviewing and discussing the literature, including a systematic review and meta-analysis published in conjunction with this document, and drawing on their own experience, drafted and voted on recommendations and summarized current knowledge and practice in the field. Each recommendation is presented in knowledge byte format and is accompanied by supportive text and references. Further sections provide a practical synopsis of the various techniques and of the specific ventricular arrhythmia sites and substrates encountered in the electrophysiology lab. The purpose of this document is to help electrophysiologists around the world to appropriately select patients for catheter ablation, to perform procedures in a safe and efficacious manner, and to provide follow-up and adjunctive care in order to obtain the best possible outcomes for patients with ventricular arrhythmias.
室性心律失常是发病率和死亡率的重要原因,有多种形式,从单个室性早搏到持续性室性心动过速和颤动。在过去的十年中,我们对这些心律失常的理解以及诊断和治疗它们的能力都取得了快速的发展。随着新方法和工具的发展以及大型临床试验的发表,导管消融领域也取得了进展。因此,全球心脏电生理专业学会承担了在一份文件中概述这些程序的建议和最佳实践,该文件将更新和取代 2009 年 EHRA/HRS 专家共识关于导管消融室性心律失常。一个专家写作小组在审查和讨论文献后,包括与本文件一起发表的系统评价和荟萃分析,并借鉴他们自己的经验,起草并投票表决建议,并总结该领域的当前知识和实践。每个建议都以知识字节的形式呈现,并附有支持性文本和参考文献。其他部分提供了各种技术以及电生理实验室中遇到的特定室性心律失常部位和基质的实用摘要。本文件的目的是帮助世界各地的电生理学家适当选择患者进行导管消融,以安全有效的方式进行手术,并提供随访和辅助治疗,以便为室性心律失常患者获得最佳结果。