Bhaskaran Ashwin, De Silva Kasun, Rao Karan, Campbell Timothy, Trivic Ivana, Bennett Richard G, Kizana Eddy, Kumar Saurabh
Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia.
Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia.
Korean Circ J. 2020 Mar;50(3):203-219. doi: 10.4070/kcj.2019.0292. Epub 2019 Oct 29.
Non-ischemic cardiomyopathies are a heterogeneous group of diseases of the myocardium that have a distinct proclivity to ventricular arrhythmias. Of these, ventricular tachycardias pose significant management challenges with the risk of sudden cardiac death and morbidity from multiple causes. Catheter ablation of ventricular tachycardias is becoming an increasingly utilised intervention that has been found to have significant benefits with improving symptoms, reducing anti-arrhythmic drug burden and debilitating device therapies, thereby improving quality of life. Nonetheless, the approach to the ablation of ventricular tachycardias in non-ischemic cardiomyopathies is governed heavily by the disease process, with several distinct differences from ischemic cardiomyopathy including a preponderance to epicardial and deep intramural substrate. This contemporary review aims to present the various disease processes within non-ischemic cardiomyopathies, catheter ablation techniques which have been developed to target ventricular tachycardia and more novel adjunctive therapeutic measures.
非缺血性心肌病是一组异质性的心肌疾病,具有明显的室性心律失常倾向。其中,室性心动过速带来了重大的管理挑战,存在心脏性猝死风险以及多种病因导致的发病风险。室性心动过速的导管消融正成为一种越来越常用的干预措施,已发现其在改善症状、减轻抗心律失常药物负担和减少使人虚弱的器械治疗方面具有显著益处,从而提高生活质量。尽管如此,非缺血性心肌病室性心动过速的消融方法在很大程度上受疾病进程的支配,与缺血性心肌病有几个明显不同之处,包括心外膜和深层壁内基质占优势。这篇当代综述旨在介绍非缺血性心肌病内的各种疾病进程、针对室性心动过速开发的导管消融技术以及更新颖的辅助治疗措施。