Department of Cardiac Electrophysiology and Arrhythmology, IRCCS Ospedale San Raffaele, Via Olgettina 60, Milan, Italy.
Curr Cardiol Rep. 2020 Jul 9;22(9):91. doi: 10.1007/s11886-020-01345-7.
Optimal timing for catheter ablation of ventricular tachycardia is an important yet unresolved subject. While it is clear that it is indicated with relatively advanced disease, it is still uncertain how early it should be recommended. In this review, we will focus on the status of timing of catheter ablation for VT in patients with ICD therapies.
The latest expert consensus statement added a new timing indication for catheter ablation after the first episode of monomorphic VT, in patients with ischemic heart disease and an ICD. Early referral for catheter ablation reduces the number of VT recurrences; however, an impact on mortality has not been demonstrated yet. Guidelines and real-world data alike show an increasing trend to refer patients after the first VT episode in ICD patients. Randomized clinical trials powered to assess mortality are essential in order confirm the beneficial effects of an early strategy.
室性心动过速（VT）导管消融的最佳时机是一个重要但尚未解决的问题。虽然很明显，在相对晚期疾病时进行导管消融是有指征的，但仍不确定应该多早推荐。在本综述中，我们将重点关注 ICD 治疗患者中 VT 导管消融时机的现状。
最新的专家共识声明增加了 ICD 治疗的缺血性心脏病患者首次单形性 VT 后导管消融的新时机指征。早期转介进行导管消融可减少 VT 复发的次数；然而，其对死亡率的影响尚未得到证实。指南和真实世界的数据都显示出一种趋势，即 ICD 患者在首次 VT 发作后进行转诊的人数不断增加。为了证实早期策略的有益效果，有必要进行旨在评估死亡率的随机临床试验。
