Campbell Timothy, Bennett Richard G, Kotake Yasuhito, Kumar Saurabh
Department of Cardiology, Westmead Hospital, Sydney, Australia.
Westmead Applied Research Centre, University of Sydney, New South Wales, Australia.
Korean Circ J. 2021 Jan;51(1):15-42. doi: 10.4070/kcj.2020.0436.
Sudden cardiac death (SCD) due to recurrent ventricular tachycardia is an important clinical sequela in patients with structural heart disease. As a result, ventricular tachycardia (VT) has emerged as a major clinical and public health problem. The mechanism of VT is predominantly mediated by re-entry in the presence of arrhythmogenic substrate (scar), though focal mechanisms are also important. Catheter ablation for VT, when compared to standard medical therapy, has been shown to improve VT-free survival and burden of device therapies. Approaches to VT ablation are dependent on the underlying disease process, broadly classified into idiopathic (no structural heart disease) or structural heart disease (ischemic or non-ischemic heart disease). This update aims to review recent advances made for the treatment of VT ablation, with respect to current clinical trials, peri-procedure risk assessments, pre-procedural cardiac imaging, electro-anatomic mapping and advances in catheter and non-catheter based ablation techniques.
结构性心脏病患者因反复室性心动过速导致的心源性猝死（SCD）是一个重要的临床后遗症。因此，室性心动过速（VT）已成为一个主要的临床和公共卫生问题。VT的机制主要由存在致心律失常基质（瘢痕）时的折返介导，尽管局灶机制也很重要。与标准药物治疗相比，VT导管消融已被证明可提高无VT生存率并减轻器械治疗负担。VT消融方法取决于潜在的疾病过程，大致分为特发性（无结构性心脏病）或结构性心脏病（缺血性或非缺血性心脏病）。本综述旨在回顾VT消融治疗的最新进展，涉及当前的临床试验、围手术期风险评估、术前心脏成像、电解剖标测以及基于导管和非导管的消融技术进展。
